No needle to fear: An approach to needle phobic patients

Document Type : Case report

Authors

Department of Nuclear Medicine and PET, Monash Health, Moorabbin Hospital PET Centre, Bentleigh, Victoria, Australia

Abstract

   18F-FDG is the most commonly used radioisotope in PET scanning and is administered intravenously. When patients cannot cannulated, there are limited options available for functional tumour assessment. A fifty year old male presented for investigation of a suspected lung carcinoma identified during investigation of pneumonia. The patient had a severe needle phobia, intellectual disabilities and multiple co-morbidities which made cannulation impossible. An alternative administration method was sought, with successful oral administration occurring in both staging and restaging scans. The scans demonstrated resolution of a suspected lung cancer indicating it was an inflammatory/infective process, preventing the need for more invasive investigative approaches. A non-invasive and positive experience allowed for accurate diagnosis and repeat imaging for this patient, enabling follow up imaging to occur. It is reported that oral administration of 18F-FDG may be useful for assessment of suspected cancers for patients where cannulation isn’t possible, when limitations are taken into consideration.

Keywords


  1. Newberg A, Alavi A, Reivich M. Determination of regional cerebral function with FDG-PET imaging in neuropsychiatric disorders. Semin Nucl Med. 2002; 32(1):13-34.
  2. Kim C, Kim IH, Kim SI, Kim YS, Kang SH, Moon SH, et al. Comparison of the Intraperitoneal, Retroorbital and per Oral Routes for F-18 FDG Administration as Effective Alternatives to Intravenous Administration in Mouse Tumor Models Using Small Animal PET/CT Studies. Nucl Med Mol Imaging. 2011; 45(3):169-76.
  3. Zhang K, Wang X, Hao L, Zhao Z, Han C. Dynamic observation of 18F-FDG uptake after oral administration in a healthy subject. J Nucl Med Technol. 2013; 41(2):78-80.
  4. Thazhath S, Wu T, Young R, Horowitz M, Rayner C. Glucose absorption in small intestinal disease. Expert Rev Gastroenterol Hepatol. 2014; 8(3):301-312.
  5. Nair N, Agrawal A, Jaiswar R. Substitution of oral (18) F-FDG for intravenous (18) F-FDG in PET scanning. J Nucl Med Technol. 2007; 35(2):100-4.
  6. Franc B, Carlisle MR, Segall G. Oral administration of F-18 FDG to evaluate a single pulmonary nodule by positron emission tomography in a patient with poor intravenous access. Clin Nucl Med. 2003; 28(7):541-4.
  7. Srinivasan S, Crandall J, Gajwani P, Sgouros G, Mena E, Lodge MA, et al. Human Radiation Dosimetry of Orally or Intravenously Administered (18)F-Fluorodeoxyglucose. J Nucl Med. 2020; 61(4):613-619.