1. 18 F-FDG Colonic Uptake by Oral Anti- Diabetic Drugs in PET/CT Scan Sang Gyu Kim, Hoon Hee Park, Jung Yul Kim, Young Kag Bahn Han Sang Lim, Jae Sam Kim, Chang Ho Lee

2. Hyperglycemia Pancreas Blood Vessel Diabetes Abnormal Insulin Diabetes Mellitus ?

3. Type 2 DM Type 1 DM NonInsulin-Dependent Diabetes MellitusNIDDM Insulin-Dependent Diabetes MellitusIDDM

4. Improves glucose tolerance in type 2 diabetes mellitus patients Lowers both basal and postprandial plasma glucose Decreases hepatic glucose production Improves insulin sensitivity by increasing peripheral glucose uptake and utilization Substantially excreted by the kidney Half-life of Metformin is approximately 6.2 hours

5. Metformin

6. Patient Population Period - January 2008 ~ August 2009 Patients Age - Group 1-a : 59.2±8.3 years old Group 1-b : 57.4±9.5 years old Group 2 : 55.2±12.8 years old Group 1 ( Experimental Group - Type 2 DM ) Group 1-a ( Include Metformin ) : 60 patients Group 1-b ( Exclude Metformin ) : 60 patients Group 2 ( Control Group - Non DM ) : 60 patients Study Case

7. Patient Population Exclusion - Type 1 DM Under 18 years old Colorectal and/or Peritoneal Carcinoma Inflammatory Bowel Disease Gastrointestinal Symptoms Other factors of patients did not concerned Except for Metformin taking

8. Reconstruction - Recon Method : Iterative Mode - Subsets : 28 / Iterations : 2 CT Component - 8 Slices - Slice Thickness : 2 mm PET Component - BGO Crystal / 3D Acq. - Intrinsic Resolution : 6 mm FWHM - Longitudinal FOV : 157 mm Discovery STe (GE Healthcare)

9. 6 Hours prior to the scan 12 Hours prior to the scan 24 Hours prior to the scan Drink Water Sufficiently Patients Preparation

10. Enhancement Channel Patient Flow List B.S.T.I.V. VoidingRestingFDG Injection Waiting

11. Image Acquisition PET Scan CT Scan Scout View Patient Preparation 15 ~ 20 Min 30 ~ 40 Sec 10 ~ 20 Sec 5 ~ 10 Min Patient Flow List 2.5 min/bed, Emission 140 kV, 30 mAs 120 kV, 10 mAs

12. Ascending Colon Transverse Colon Descending Colon Data Analysis SUVmax ( Mean±SD ) Software - Advantage Workstation Ver. 4.3 ( GE Healthcare ) ROI ( Region Of Interest ) - 500 mm 2 2 Nuclear Physician and 1 Radiologic Technologist Statistics - Program: SPSS Ver. 17. ( SPSS inc., USA ) Descriptive Statistics ONEWAY ANOVA Method - LSD P Value < 0.05

13. Group 1 ( Type 2 DM ) † Group 2 *† Group 1-a * Group 1-b ( Non DM ) Ascending 6.2 ± 3.63.1 ± 1.42.0 ± 0.9 Transverse 4.4 ± 2.92.1 ± 1.01.7 ± 0.9 Descending 5.5 ± 2.43.2 ± 1.82.2 ± 1.9 Group 1 : Experimental Group ( Type 2 DM ) Group 1-a : Include Metformin Group 1-b : Exclude Metformin Group 2 : Control Group ( Non DM ) Table 1. Maximum Standardized Uptake Values * Group 1-a, Group 1-b : P < 0.001 / † Group 1-a, Group 2 : P < 0.001

14. Box Plot. Group Comparison - SUVmax Group 1-a A DT Group 2 DTA Group 1-b DTA ( Include Metformin ) * A : Ascending Colon, T : Transverse Colon, D : Descending Colon ( Exclude Metformin )( Non DM )

15. Exclude Metformin Include Metformin

16. There was a limitation that we did not have the data comparing when patients took antidiabetic drug and when patients did not take it for the same patients. Limitation

17. Thus, it could be helpful for the results by identifying the ingredient of antidiabetic drug before the examination and the possibility of interpretation of false-positive will be reduced The effect of the intake of Metformin was observed from the SUV on region of large bowel in this study This will be considered to helpful to the study of comparison with other ingredient of antidiabetic drug Conclusion