The Basics
What is Fludeoxyglucose F18?
Used to help diagnose cancer, heart disease, and epilepsy in a PET scan.
Brand names for Fludeoxyglucose F18
Fludeoxyglucose F 18 Injection
How Fludeoxyglucose F18 is classified
Radiopharmaceuticals, Diagnostic Agents
Fludeoxyglucose F18 During Pregnancy
Fludeoxyglucose F18 pregnancy category
Category CNote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.
What we know about taking Fludeoxyglucose F18 while pregnant
N/A
Taking Fludeoxyglucose F18 While Breastfeeding
What are recommendations for lactation if you're taking Fludeoxyglucose F18?
Information in this record refers to the use of fludeoxyglucose F18 (18F-FDG) as a diagnostic agent. 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.[1] The amounts of 18F-FDG excreted in breastmilk after a PET scan are below the level of concern for the breastfed infant and most international radiation safety organizations state that no interruption of breastfeeding is necessary.[2][3][4][5] However, to follow the principle of keeping exposure as low as reasonably achievable , some guidelines recommend withholding breastfeeding for 1 to 4 hours.[6][7] 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.[1][8][9][10] 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.[1][2][8][11] Nursing mothers should not work with radioactive substances used in PET scans in their workplace.[12]
Maternal / infant drug levels
Information in this record refers to the use of fludeoxyglucose F18 (18F-FDG) as a diagnostic agent. 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.[1] The amounts of 18F-FDG excreted in breastmilk after a PET scan are below the level of concern for the breastfed infant and most international radiation safety organizations state that no interruption of breastfeeding is necessary.[2][3][4][5] However, to follow the principle of keeping exposure as low as reasonably achievable , some guidelines recommend withholding breastfeeding for 1 to 4 hours.[6][7] 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.[1][8][9][10] 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.[1][2][8][11] Nursing mothers should not work with radioactive substances used in PET scans in their workplace.[12]
Possible effects of Fludeoxyglucose F18 on milk supply
Relevant published information was not found as of the revision date.
Possible alternatives to Fludeoxyglucose F18
None listed
List of References
Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. 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
2. 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
3. Dorbala S, Di Carli MF, Delbeke D et al. SNMMI/ASNC/SCCT guideline for cardiac SPECT/CT and PET/CT 1.0. J Nucl Med. 2013;54:1485-507. PMID: 23781013
4. Mattsson S, Johansson L, Leide Svegborn S et al. Radiation dose to patients from radiopharmaceuticals: A compendium of current information related to frequently used substances. Annex D. Recommendations on breast-feeding interruptions. Ann ICRP. 2015;44 (2 Suppl):319-21. PMID: 26069086
5. Leide-Svegborn S, Ahlgren L, Johansson L et al. Excretion of radionuclides in human breast milk after nuclear medicine examinations. Biokinetic and dosimetric data and recommendations on breastfeeding interruption. Eur J Nucl Med Mol Imaging. 2016;43:808-21. PMID: 26732471
6. International Atomic Energy Agency. Radiation Protection and Safety in Medical Uses of Ionizing Radiation, IAEA Safety Standards Series No. SSG-46, IAEA, Vienna. 2018. https://www.iaea.org/publications/11102/radiation-protection-and-safety-in-medical-uses-of-ionizing-radiation
7. National Radiation Protection Board (UK). Administration of radioactive substances advisory committee. Notes for guidance on the clinical administration of radiopharmaceuticals and use of sealed radioactive sources. 2019. https://assets.publishing.service.gov.uk/government/…/file/…/ARSAC_NfG_2019.pdf
8. 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
9. Devine CE, Mawlawi O. Radiation safety with positron emission tomography and computed tomography. Semin Ultrasound CT MR. 2010;31:39-45. PMID: 20102694
10. Hendler D, Stemmer SM. Uncommon reason for high fluorodeoxyglucose positron emission tomography uptake. J Clin Oncol. 2010;28:e659-60. PMID: 20713861
11. Boellaard R, Delgado-Bolton R, Oyen WJ, Giammarile F, Tatsch K, Eschner W et al. FDG PET/CT: EANM procedure guidelines for tumour imaging: version 2.0. Eur J Nucl Med Mol Imaging. 2015;42:328-54. PMID: 25452219
12. Almen A, Mattsson S. Radiological protection of foetuses and breast-fed children of occupationally exposed women in nuclear medicine – Challenges for hospitals. Phys Med. 2017;43:172-7. PMID: 28882410
Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.
