Blood Film Analysis after FDG-PET Imaging: Unveiling Hematological and Radiological Changes
Main Article Content
Abstract
Positron emission tomography (PET) using ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) is a cornerstone in oncological imaging for tumor localization and therapeutic assessment. Despite its diagnostic utility, limited attention has been given to its transient effects on hematological parameters. This study evaluates hematologic and immunological alterations following FDG administration by analyzing changes in red blood cells (RBCs), white blood cells (WBCs), and platelets before and after injection. The experimental cohort included one healthy subject and three cancer patients (liver, breast, and uterine). Peripheral blood samples were obtained pre- and post-FDG injection, with subsequent blood film analysis assessing RBC aggregation, WBC distribution, platelet morphology, and indicators of blood viscosity. Findings revealed reversible hematological changes, notably increased RBC aggregation, suggesting transient hyperviscosity potentially driven by oxidative stress. Differential leukocyte analysis revealed neutrophilia, lymphopenia, and monocytosis, suggesting immune modulation. Additionally, a mild rise in platelet aggregation suggested a temporary prothrombotic state. The study concludes that FDG-PET elicits short-term hematological and immunological shifts. These outcomes highlight the importance of cautious interpretation of PET findings in oncology settings and emphasize the need for further investigations into oxidative and immunomodulatory effects to enhance patient safety and diagnostic accuracy.
Article Details
Issue
Section
This work is licensed under a Creative Commons Attribution 4.0 International License.
© 2023 The Author(s). Published by the College of Science, University of Baghdad. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License.
How to Cite
References
1. D. J. Macfarlane, L. Yu, and C. Y. H. Chao, Positron emission tomography/computed tomography (PET/CT) in oncological diagnostics: clinical applications and future perspectives, J. Med. Imaging Radiat. Oncol., 64(3), 345 (2020). https://doi.org/10.1111/1754-9485.13012.
2. A. B. Hade and S. I. Essa, Evaluation of the Influence of Body Mass Index and Signal-to-Noise Ratio on the PET/CT Image Quality in Iraqi Patients with Liver Cancer. East Eur. J. Phys., (1), 241 (2023). https://doi.org/10.26565/2312-4334-2023-1-32.
3. S. Z. Abdehvand, R.Csipkés, Attila Forgács, G. Trencsényi, I. Garai, I. Komlósi, Using PET/CT imaging performance to qualify 18 F-Fluorodeoxy- glucose (FDG) uptake in common carp (Cyprinus carpio). Iraqi J. Sci., 6(5), 2000 (2022). https://doi.org/10.24996/ijs.2022.63.5.15.
4. A. B. Hade and S. I. Essa, evaluation of the effect of the injected dose and body mass index on the signal-to-noise ratio (SNR) detected using a PET/CT scan. J. Pre. Clin. Clin. Res., 10(1), 60 (2016). https://doi.org/10.5604/18982395.1208191.
5. B. J. Bain, Diagnosis from the blood smear, N. Engl. J. Med., 353(5), 498 (2005). https://doi.org/10.1056/NEJMra043442.
6. K. Agrawal, J. Weaver, R. Ngu, and M. Krishnamurthy, Clinical significance of patterns of incidental thyroid uptake at (18)F-FDG PET/CT. Clin. Radiol., 70(5), 536 (2015). https://doi.org/10.1016/j.crad.2014.12.020.
7. A. Culverwell, A. Scarsbrook, and F. Chowdhury, False-positive uptake on 2-[18F]-fluoro-2-deoxy-D-glucose (FDG) positron-emission tomography/computed tomography (PET/CT) in oncological imaging. Clin. Radiol., 66(4), 366 (2011). https://doi.org/10.1016/j.crad.2010.12.004.
8. P. Sakthivel, A. Kumar, S. T. Arunraj, K. Thakur, A. S. Jaiswal, C. A. Singh, and R. Kumar, 68Ga-prostate-specific membrane antigen PET/CT in sinonasal glomangiopericytoma-exploring theranostic avenues!.Clin. Nucl. Med., 46(4), 340 (2021). https://doi.org/10.1097/RLU.0000000000003467.
9. E. Gallagher, C. Hou, Y. Zhu, C-J Hsieh, H. Lee, S. Li, K. Xu, P. Handerson, et al. Positron emission tomography with [18F]ROStrace reveals progressive elevations in oxidative stress in a mouse model of Alpha-Synucleinopathy. Int. J. Mol. Sci., 25(9), 4943 (2024). https://doi.org/10.3390/ijms25094943.
10. C. J. Hsieh, C. Hou, Y. Zhu, J. Y. Lee, N. Kohli, E. Gallagher, K. Xu, H. Lee, S. Li, M. J. McManus, and R. H. Mach, [18F]ROStrace detects oxidative stress in vivo and predicts progression of Alzheimer’s disease pathology in APP/PS1 mice. EJNMMI Res., 12(1), 43 (2022). https://doi.org/10.1186/s13550-022-00914-x.
11. F. Tustumi, D. G. Albenda, F. S. Perrotta, R. A. A. Sallum, U. Ribeiro Junior, C. A. Buchpiguel, and P. S. Duarte, Prognostic value of bone marrow uptake using 18F-FDG PET/CT scans in solid neoplasms. J. Imaging, 8(11), 297 (2022). https://doi.org/10.3390/jimaging8110297.
12. X. Li, C. Dong, X. Ma, and Y. Wang, 18F-FDG PET/CT associates with disease activity and clinical recurrence of AOSD patients. Front. Med., 8, 668323 (2021). https://doi.org/10.3389/fmed.2021.668323.
13. J. L. Ward, Y. Wu, C. Harflett, H. Onafuye, D. Corol, C. Lomax, W. J. Macalpine, J. Jr. Cinatl, M. N. Wass, M. Michaelis and M. H. Beale, Miyabeacin: A new cyclodimer presents a potential role for willow in cancer therapy. Sci. Rep., 10, 6477 (2020). https://doi.org/10.1038/s41598-020-63349-1.
14. C. W. Kessinger, G. Qi, M. Z. O. Hassan, P. K. Henke, A. Tawakol, and F. A. Jaffer, Fluorodeoxyglucose positron emission tomography/computed tomography imaging predicts vein wall scarring and statin benefit in murine venous thrombosis. Circ. Cardiovasc. Imaging, 14(3), (2020). https://doi.org/10.1161/CIRCIMAGING.120.011898.
15. W.-Y. Yin, J. Yuan, and Z.-M. Zhang, C. Mei, W. Xu, Y.-X. Tang, F. Peng, and N. Li, 18F-fluorodeoxyglucose positron emission tomography–computed tomography for assessing organ distribution of stressed red blood cells in mice. Sci. Rep., 11, 2505 (2021). https://doi.org/10.1038/s41598-021-82100-y.
16. X. Yu, S. Wang, N. Du, H. Zhao, and H. Chen, Diagnostic efficacy and necessity of 18F-FDG PET/CT in fever of unknown origin: insights from a retrospective cohort study. Front. Med., 11, 1511710 (2025). https://doi.org/10.3389/fmed.2024.1511710.
17. H. L. Teague, N. J. Varghese, L. C. Tsoi, A. K. Dey, M. S. Garshick, J. I. Silverman, Y. Baumer, et al., Neutrophil subsets, platelets, and vascular disease in psoriasis. JACC Basic Transl. Sci., 4(1), 1 (2019). https://doi.org/10.1016/j.jacbts.2018.10.008.
18. E. M. Triviño-Ibáñez, B. M. Jiménez-Rodríguez, T. Rudolphi-Solero, E. Y. García-Rivero, A. Rodríguez-Fernández, J. M. Llamas-Elvira, M. Gómez-Río, and C. Morales-García. [18F]FDG PET/CT in short-term complications of COVID-19: metabolic markers of persistent inflammation and impaired respiratory function. Diagnostics, 12(4), 835 (2022). https://doi.org/10.3390/diagnostics12040835.
19. Y. Matsusaka, T. Nakahara, K. Takahashi, Y. Iwabuchi, C. Nishime, M. Kajimura, and M. Jinzaki, 18F-FDG-labeled red blood cell PET for blood-pool imaging: preclinical evaluation in rats. EJNMMI Res., 7(19), 66 (2017). https://doi.org/10.1186/s13550-017-0266-3.
20. A. M. Ikawa, H. Okazawa, Y. Nakamoto, M. Yoneda, PET image for oxidative stress in neurodegenerative disorders associated with mitochondrial dysfunction. Antioxidants, 9(9), 861 (2020). https://doi.org/10.3390/antiox9090861.