Effect of diabetes on the radiopharmaceutical dose uptake in radiodiagnosis using PET scanning

Abstract

Objectives: This study aimed to compare liver uptake of radiopharmaceuticals in diabetic and non-diabetic patients using PET scanning, and to evaluate the influence of body weight and body mass index (BMI) on radiopharmaceutical uptake.

Methods: A total of 150 patients (75 males and 75 females), aged 31–75 years, were enrolled between November 2024 and April 2025. Participants were divided into three groups: control (normal liver, n = 50), liver cancer without diabetes (n = 50), and liver cancer with diabetes (n = 50). All patients underwent PET/CT imaging after intravenous injection of 18F-FDG (0.1 MBq/kg). Standard Uptake Values (SUVs) were recorded and analysed across weight categories (50–100 kg).

Results: Mean SUVs were significantly higher in patients with liver cancer compared with controls (e.g., males: 3.32 ± 0.35 vs. 1.49 ± 0.23; females: 3.38 ± 0.35 vs. 1.55 ± 0.23; P < 0.001). Patients with liver cancer and diabetes showed further increases (e.g., males: 3.99 ± 0.35; females: 4.15 ± 0.45), which were significantly different from both controls (P < 0.001) and liver cancer patients without diabetes (P < 0.01). Across both sexes, SUVs rose progressively with body weight, with the highest values observed in the 91–100 kg category.

Conclusion: Diabetes and higher body weight/BMI are associated with significantly greater FDG uptake in the liver during PET/CT imaging. These factors should be considered in image interpretation to avoid potential overestimation of malignant activity.