Fluorodeoxyglucose F18 use while Breastfeeding

Fluorodeoxyglucose F18 Levels and Effects while Breastfeeding

Summary of Use during Lactation

Information in this record refers to the use of fluorodeoxyglucose F18 (18F-FDG) as a diagnostic agent. Elective diagnostic nuclear medicine procedures generally should be delayed until the patient is no longer breastfeeding.[1] The use of 18F FDG in positron emission tomography (PET) scans may be preferable to other types of scans during breastfeeding because of the low levels and rapid disappearance of radiation.[2]

The amounts of 18F-FDG excreted in breastmilk after a PET scan are below the level of concern for the breastfed infant and numerous international radiation safety organizations state that no interruption of breastfeeding is necessary.[3][4][5] However, because of extensive uptake by lactating breasts and the consequent external radiation, nursing mothers should refrain from prolonged close contact with their infants for a period of time.[2][6][7][8] Some authors suggest that the infant be bottle fed with expressed breastmilk by a third person for 1 feeding or 4 to 12 hours, depending on the dose, after a PET scan with 18F-FDG in a nursing mother.[2][5][6]

Drug Levels

F18 is a positron emitter with a principal decay energy of 0.6335 MeV, annihilation photons of 0.511 MeV, and a physical half-life of 1.83 hours.

Maternal Levels. Four women provided milk samples after being given 18F-FDG for a PET scan. Doses ranged from 50 to 160 MBq. Three gave a single milk sample and one gave 4 samples between 0.75 and 3.5 hours after the dose. The authors calculated that the maximum radioactivity in milk would be 19 Bq/mL for each MBq administered and that peak activity in breastmilk would occur 3 hours after administration.[2] Many diagnostic studies are performed using doses up to 370 MBq, which may require a longer period of breastfeeding abstinence.

Infant Levels. Relevant published information was not found as of the revision date.

Effects in Breastfed Infants

Relevant published information was not found as of the revision date.

Possible Effects on Lactation

Relevant published information was not found as of the revision date.

References

1. Parker JA, Daube-Witherspoon ME, Graham LS et al. Procedure guideline for general imaging: 3.0. Society of Nuclear Medicine. 2004. http://interactive.snm.org/docs/General_Imaging_v3.0.pdf

2. Hicks RJ, Binns D, Stabin MG. Pattern of uptake and excretion of 18F-FDG in the lactating breast. J Nucl Med. 2001;42:1238-42. PMID: 11483686

3. ICRP. Radiation dose to patients from radiopharmaceuticals. Addendum 3 to ICRP Publication 53. ICRP Publication 106. Annex D. Ann ICRP. 2008;38:163-84. PMID: 19154964

4. Leide-Svegborn S. Radiation exposure of patients and personnel from a PET/CT procedure with 18F-FDG. Radiat Prot Dosimetry. 2010;139:208-13. PMID: 20167792

5. Jamar F, Buscombe J, Chiti A et al. EANM/SNMMI guideline for 18F-FDG use in inflammation and infection. J Nucl Med. 2013;54:647-58. PMID: 23359660

6. Devine CE, Mawlawi O. Radiation safety with positron emission tomography and computed tomography. Semin Ultrasound CT MR. 2010;31:39-45. PMID: 20102694

7. Hendler D, Stemmer SM. Uncommon reason for high fluorodeoxyglucose positron emission tomography uptake. J Clin Oncol. 2010;28:e659-60. PMID: 20713861

8. Segall G, Delbeke D, Stabin MG et al. SNM practice guideline for sodium 18F-fluoride PET/CT bone scans 1.0. J Nucl Med. 2010;51:1813-20. PMID: 21051652

Fluorodeoxyglucose F18 Identification

Substance Name

Fluorodeoxyglucose F18

CAS Registry Number

63503-12-8

Drug Class

Administrative Information

LactMed Record Number

810

Information from the National Library of Medicine's LactMed Database.

Last Revision Date

2013-09-07

Disclaimer

Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.

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