[ 18F]FDG uptake may be changed by fasting or by blood sugar changes associated with diabetic mellitus. Blood glucose levels should be stabilized in non-diabetic patients by fasting before [ 18F]FDG injection. Diabetic patients may need stabilization of blood glucose on the day preceding and on the day of the [ 18F]FDG scan.
The recommended dose of [ 18F]FDG for an adult (70 kg) is within the range 185-370 MBq (5-10 mCi), intravenous injection. In children doses as low as 2.6 mCi have been given. Optimal dose reductions for children have not been confirmed.
The optimum rate of administration and upper safe dose for [ 18F]FDG have not been established. The time interval between doses of [ 18F]FDG should be long enough to allow substantial decay (physical and biological) of previous administrations.
It is recommended that PET imaging be initiated within 40 minutes of [ 18F]FDG injection.
The final dose for the patient should be calculated using proper decay factors from the time of the EOS, and measured by a suitable radioactivity calibration system before administration. See decay factors in Table 3.
[ 18F]FDG, like other parenteral drug products, should be inspected visually for particulate matter and discoloration before administration, whenever solution and container permit. Preparations containing particulate matter or discoloration should not be administered. They should be disposed of in a safe manner, in compliance with applicable regulations.
[ 18F]FDG should be stored upright in a lead shielded environment at controlled room temperature.
Aseptic techniques and effective shielding should be employed in withdrawing doses for administration to patients. Waterproof gloves and effective shielding should be worn when handling the product.