Ketosis in FDG metabolism in known malignancy
Research type
Research Study
Full title
The effect of ketosis on FDG metabolism and PET-CT image quality in cancer
IRAS ID
253859
Contact name
Manil Subesinghe
Contact email
Sponsor organisation
King's College London
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
2-deoxy-2-[18F]fluoro-D-glucose (FDG) positron emission tomography-computed tomography (PET-CT) is a cancer imaging technique, which involves injecting a weakly radioactive form of glucose or 'sugar' known as fluorodeoxyglucose (FDG) into the bloodstream. Cancer cells use glucose to generate energy and so accumulate large amounts of FDG, making them visible and readily detectable on PET images.
However, normal cells use glucose for energy, making them also visible on PET images. This can sometimes make it difficult to identify where cancer cells are or where they have spread to, especially if some cancers demonstrate very little FDG uptake compared to nearby normal tissues or if cancer cells are located in organs which utilise large amounts of glucose, i.e. the brain.
Ketones are natural substances produced by burning fat and represent an evolutionary response to sustain life in response to situations where carbohydrate (glucose) intake/stores are low, e.g. starvation. Ketones acts as fuels for energy but importantly are also able control the choice of fuel used by normal cells, by reducing the amount of glucose being burnt for energy.
We believe that, by using a ketone drink to elevate circulating ketone levels in the bloodstream, equivalent to several days’ worth of fasting (ketosis), it will reduce the number of normal cells utilising glucose and in turn lead to fewer normal cells being visible on the PET images, thereby beneficially influencing image quality.
57 patients with proven cancer already undergoing a FDG PET-CT as part of their routine clinical management, will be invited to return the King’s College London & Guy’s and St. Thomas’ (KCL/GSTT) PET Centre, for an additional research FDG PET-CT scan, within 15 working days of their clinical study, which will only differ by the ingestion of a ketone drink prior to scanning. The study is being funded by the Medical Research Council.
REC name
London - Westminster Research Ethics Committee
REC reference
19/LO/0980
Date of REC Opinion
2 Oct 2019
REC opinion
Further Information Favourable Opinion