Evidence mapPaperPMID 41396349Full record

ArticleAnnals of nuclear medicine2026

Utility of serum blood ketone levels and other risk factors for inadequate myocardial glucose suppression ketogenic FDG-PET/CT: a prospective and retrospective cohort study.

Ya Ruth Huo, Sandeep Gupta, Natalie Rutherford, Megan Saul, Michael Vinchill Chan

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Article in Annals of nuclear medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 authors.

Ya Ruth HuoDepartment of Nuclear Medicine, John Hunter Hospital, Newcastle, NSW, Australia. ruth.huo@gmail.com.ORCID http://orcid.org/0000-0001-6282-7677
Sandeep GuptaDepartment of Nuclear Medicine, John Hunter Hospital, Newcastle, NSW, Australia.
Natalie RutherfordDepartment of Nuclear Medicine, John Hunter Hospital, Newcastle, NSW, Australia.
Megan SaulDepartment of Nuclear Medicine, John Hunter Hospital, Newcastle, NSW, Australia.
Michael Vinchill ChanDepartment of Radiology, Concord General Repatriation Hospital, Concord, NSW, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesIncomplete myocardial glucose suppression (MGS) in ketogenic 18F-FDG-PET/CT is a common problem that reduces the diagnostic accuracy in detecting myocardial inflammation. This study assesses the usefulness of a dietary logbook, blood ketone testing and risk factors for inadequate MGS.

methodsRetrospective (2022-2024) and prospective (2024-2025) analysis was performed on all patients who underwent a ketogenic 18F-FDG-PET/CT at two tertiary hospitals. All patients were instructed to follow > 24-hour ketogenic diet and > 12-hour fast before imaging. In April 2024, blood ketone testing, a dietary logbook, and improved dietary guidelines were introduced.

resultsAfter introducing the dietary logbook and improved dietary guidelines, inadequate MGS rates decreased from 26% to 17% (95 patients 2022-2024 vs. 92 patients 2024-2025)(p-value 0.14). Mean blood ketone levels were significantly lower in patients with incomplete MGS (0.34mmol/L vs. 0.76mmol/L, p-value 0.04). On univariate analysis, significant risk factors for inadequate MGS included prednisolone use (75% vs. 14.9%, OR: 17.1 [95%CI 1.65-177.04], p = 0.009), low blood ketones (≤ 0.3mmol/L)(OR: 5.77 [95%CI 1.69-19.68], p = 0.003) and female sex (27.5% vs. 9.6% in males, OR: 3.57 [95%CI 1.12-11.3], p = 0.025). Multivariate analysis confirmed prednisolone use, low ketones (≤ 0.3mmol/L) and < 24-hour ketogenic diet as independent risk factors for inadequate MGS. Rates of inadequate MGS were 50%, 26% and 7% for patients with blood ketone levels of 0.1, 0.2-0.3 and ≥ 0.4mmol/L, respectively. All patients on prednisolone with ketones ≤ 0.3mmol/L had inadequate MGS.

conclusionsDietary logbook and clear instructions improve adherence. Low ketones, prednisolone use and short ketogenic preparation are risk factors for inadequate MGS.

Indexed as

Fluorodeoxyglucose F18GlucoseKetonesMyocardiumPositron Emission Tomography Computed TomographyAdultAgedDiet, KetogenicFemaleHumansMaleMiddle AgedProspective StudiesRetrospective StudiesRisk FactorsFluorodeoxyglucose F18GlucoseKetonesCardiac sarcoidosisKetogenicKetoneMyocardial glucose suppressionPET/CTβ-hydroxybutyrate

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PMID41396349

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.