Skip to main content
Top
Published in: Pediatric Radiology 6/2011

01-06-2011 | Pictorial Essay

Brown adipose tissue 18F-FDG uptake in pediatric PET/CT imaging

Authors: Terence S. Hong, Amer Shammas, Martin Charron, Katherine A. Zukotynski, Laura A. Drubach, Ruth Lim

Published in: Pediatric Radiology | Issue 6/2011

Login to get access

Abstract

Positron emission tomography (PET) using [F-18]2-fluoro-2-deoxyglucose (FDG) fused with CT (18F-FDG PET/CT) has been widely adopted in oncological imaging. However, it is known that benign lesions and other metabolically active tissues, such as brown adipose tissue (BAT), can accumulate 18F-FDG, potentially resulting in false-positive interpretation. Previous studies have reported that 18F-FDG uptake in BAT is more common in children than in adults. We illustrate BAT FDG uptake in various anatomical locations in children and adolescents. We also review what is known about the effects of patient-related physical attributes and environmental temperatures on BAT FDG uptake, and discuss methods used to reduce BAT FDG uptake on 18F-FDG PET.
Literature
1.
go back to reference Depas G, De Barsy C, Jerusalem G et al (2005) 18F-FDG PET in children with lymphomas. Eur J Nucl Med Mol Imaging 32:31–38PubMedCrossRef Depas G, De Barsy C, Jerusalem G et al (2005) 18F-FDG PET in children with lymphomas. Eur J Nucl Med Mol Imaging 32:31–38PubMedCrossRef
2.
go back to reference Franzius C, Schober O (2003) Assessment of therapy response by FDG PET in pediatric patients. Q J Nucl Med 47:41–45PubMed Franzius C, Schober O (2003) Assessment of therapy response by FDG PET in pediatric patients. Q J Nucl Med 47:41–45PubMed
3.
go back to reference Hudson MM, Krasin MJ, Kaste SC (2004) PET imaging in pediatric Hodgkin’s lymphoma. Pediatr Radiol 34:190–198PubMedCrossRef Hudson MM, Krasin MJ, Kaste SC (2004) PET imaging in pediatric Hodgkin’s lymphoma. Pediatr Radiol 34:190–198PubMedCrossRef
4.
go back to reference Shulkin BL, Mitchell DS, Ungar DR et al (1995) Neoplasms in a pediatric population: 2-[F-18]-fluoro-2-deoxy-D-glucose PET studies. Radiology 194:495–500PubMed Shulkin BL, Mitchell DS, Ungar DR et al (1995) Neoplasms in a pediatric population: 2-[F-18]-fluoro-2-deoxy-D-glucose PET studies. Radiology 194:495–500PubMed
5.
go back to reference Tatsumi M, Miller JH, Wahl RL (2007) 18F-FDG PET/CT in evaluating non-CNS pediatric malignancies. J Nucl Med 48:1923–1931PubMedCrossRef Tatsumi M, Miller JH, Wahl RL (2007) 18F-FDG PET/CT in evaluating non-CNS pediatric malignancies. J Nucl Med 48:1923–1931PubMedCrossRef
6.
go back to reference Abouzied MM, Crawford ES, Nabi HA (2005) 18F-FDG imaging: pitfalls and artifacts. J Nucl Med Technol 33:145–155, quiz 162–163PubMed Abouzied MM, Crawford ES, Nabi HA (2005) 18F-FDG imaging: pitfalls and artifacts. J Nucl Med Technol 33:145–155, quiz 162–163PubMed
7.
go back to reference O’Hara SM, Donnelly LF, Coleman RE (1999) Pediatric body applications of FDG PET. AJR 172:1019–1024PubMed O’Hara SM, Donnelly LF, Coleman RE (1999) Pediatric body applications of FDG PET. AJR 172:1019–1024PubMed
8.
9.
go back to reference Cohade C, Osman M, Pannu HK et al (2003) Uptake in supraclavicular area fat (‘USA-fat’): description on 18F-FDG PET/CT. J Nucl Med 44:170–176PubMed Cohade C, Osman M, Pannu HK et al (2003) Uptake in supraclavicular area fat (‘USA-fat’): description on 18F-FDG PET/CT. J Nucl Med 44:170–176PubMed
10.
go back to reference Truong MT, Erasmus JJ, Munden RF et al (2004) Focal FDG uptake in mediastinal brown fat mimicking malignancy: a potential pitfall resolved on PET/CT. AJR 183:1127–1132PubMed Truong MT, Erasmus JJ, Munden RF et al (2004) Focal FDG uptake in mediastinal brown fat mimicking malignancy: a potential pitfall resolved on PET/CT. AJR 183:1127–1132PubMed
11.
go back to reference Yeung HW, Grewal RK, Gonen M et al (2003) Patterns of (18)F-FDG uptake in adipose tissue and muscle: a potential source of false-positives for PET. J Nucl Med 44:1789–1796PubMed Yeung HW, Grewal RK, Gonen M et al (2003) Patterns of (18)F-FDG uptake in adipose tissue and muscle: a potential source of false-positives for PET. J Nucl Med 44:1789–1796PubMed
12.
go back to reference Heaton JM (1972) The distribution of brown adipose tissue in the human. J Anat 112:35–39PubMed Heaton JM (1972) The distribution of brown adipose tissue in the human. J Anat 112:35–39PubMed
13.
go back to reference Cohade C (2010) Altered biodistribution on FDG-PET with emphasis on brown fat and insulin effect. Semin Nucl Med 40:283–293PubMedCrossRef Cohade C (2010) Altered biodistribution on FDG-PET with emphasis on brown fat and insulin effect. Semin Nucl Med 40:283–293PubMedCrossRef
14.
go back to reference Cannon B, Nedergaard J (2004) Brown adipose tissue: function and physiological significance. Physiol Rev 84:277–359PubMedCrossRef Cannon B, Nedergaard J (2004) Brown adipose tissue: function and physiological significance. Physiol Rev 84:277–359PubMedCrossRef
15.
go back to reference Nedergaard J, Bengtsson T, Cannon B (2007) Unexpected evidence for active brown adipose tissue in adult humans. Am J Physiol Endocrinol Metab 293:E444–452PubMedCrossRef Nedergaard J, Bengtsson T, Cannon B (2007) Unexpected evidence for active brown adipose tissue in adult humans. Am J Physiol Endocrinol Metab 293:E444–452PubMedCrossRef
16.
go back to reference Del Mar Gonzalez-Barroso M, Ricquier D, Cassard-Doulcier AM (2000) The human uncoupling protein-1 gene (UCP1): present status and perspectives in obesity research. Obes Rev 1:61–72CrossRef Del Mar Gonzalez-Barroso M, Ricquier D, Cassard-Doulcier AM (2000) The human uncoupling protein-1 gene (UCP1): present status and perspectives in obesity research. Obes Rev 1:61–72CrossRef
17.
go back to reference Nicholls DG, Rial E (1999) A history of the first uncoupling protein, UCP1. J Bioenerg Biomembr 31:399–406PubMedCrossRef Nicholls DG, Rial E (1999) A history of the first uncoupling protein, UCP1. J Bioenerg Biomembr 31:399–406PubMedCrossRef
18.
go back to reference Kawashita NH, Brito MN, Brito SR et al (2002) Glucose uptake, glucose transporter GLUT4, and glycolytic enzymes in brown adipose tissue from rats adapted to a high-protein diet. Metabolism 51:1501–1505PubMedCrossRef Kawashita NH, Brito MN, Brito SR et al (2002) Glucose uptake, glucose transporter GLUT4, and glycolytic enzymes in brown adipose tissue from rats adapted to a high-protein diet. Metabolism 51:1501–1505PubMedCrossRef
19.
go back to reference Olichon-Berthe C, Van Obberghen E, Le Marchand-Brustel Y (1992) Effect of cold acclimation on the expression of glucose transporter GLUT 4. Mol Cell Endocrinol 89:11–18PubMedCrossRef Olichon-Berthe C, Van Obberghen E, Le Marchand-Brustel Y (1992) Effect of cold acclimation on the expression of glucose transporter GLUT 4. Mol Cell Endocrinol 89:11–18PubMedCrossRef
20.
go back to reference Lardinois D, Weder W, Hany TF et al (2003) Staging of non-small-cell lung cancer with integrated positron-emission tomography and computed tomography. N Engl J Med 348:2500–2507PubMedCrossRef Lardinois D, Weder W, Hany TF et al (2003) Staging of non-small-cell lung cancer with integrated positron-emission tomography and computed tomography. N Engl J Med 348:2500–2507PubMedCrossRef
21.
go back to reference Okuyama C, Sakane N, Yoshida T et al (2002) (123)I- or (125)I-metaiodobenzylguanidine visualization of brown adipose tissue. J Nucl Med 43:1234–1240PubMed Okuyama C, Sakane N, Yoshida T et al (2002) (123)I- or (125)I-metaiodobenzylguanidine visualization of brown adipose tissue. J Nucl Med 43:1234–1240PubMed
22.
go back to reference Barrington SF, Maisey MN (1996) Skeletal muscle uptake of fluorine-18-FDG: effect of oral diazepam. J Nucl Med 37:1127–1129PubMed Barrington SF, Maisey MN (1996) Skeletal muscle uptake of fluorine-18-FDG: effect of oral diazepam. J Nucl Med 37:1127–1129PubMed
23.
go back to reference Hany TF, Gharehpapagh E, Kamel EM et al (2002) Brown adipose tissue: a factor to consider in symmetrical tracer uptake in the neck and upper chest region. Eur J Nucl Med Mol Imaging 29:1393–1398PubMedCrossRef Hany TF, Gharehpapagh E, Kamel EM et al (2002) Brown adipose tissue: a factor to consider in symmetrical tracer uptake in the neck and upper chest region. Eur J Nucl Med Mol Imaging 29:1393–1398PubMedCrossRef
24.
go back to reference Gelfand MJ, O'Hara SM, Curtwright LA et al (2005) Pre-medication to block [(18)F]FDG uptake in the brown adipose tissue of pediatric and adolescent patients. Pediatr Radiol 35:984–990PubMedCrossRef Gelfand MJ, O'Hara SM, Curtwright LA et al (2005) Pre-medication to block [(18)F]FDG uptake in the brown adipose tissue of pediatric and adolescent patients. Pediatr Radiol 35:984–990PubMedCrossRef
25.
go back to reference Cypess AM, Lehman S, Williams G et al (2009) Identification and importance of brown adipose tissue in adult humans. N Engl J Med 360:1509–1517PubMedCrossRef Cypess AM, Lehman S, Williams G et al (2009) Identification and importance of brown adipose tissue in adult humans. N Engl J Med 360:1509–1517PubMedCrossRef
26.
go back to reference Rodriguez-Cuenca S, Pujol E, Justo R et al (2002) Sex-dependent thermogenesis, differences in mitochondrial morphology and function, and adrenergic response in brown adipose tissue. J Biol Chem 277:42958–42963PubMedCrossRef Rodriguez-Cuenca S, Pujol E, Justo R et al (2002) Sex-dependent thermogenesis, differences in mitochondrial morphology and function, and adrenergic response in brown adipose tissue. J Biol Chem 277:42958–42963PubMedCrossRef
27.
go back to reference Tennefors C, Forsum E (2004) Assessment of body fatness in young children using the skinfold technique and BMI vs. body water dilution. Eur J Clin Nutr 58:541–547PubMedCrossRef Tennefors C, Forsum E (2004) Assessment of body fatness in young children using the skinfold technique and BMI vs. body water dilution. Eur J Clin Nutr 58:541–547PubMedCrossRef
28.
go back to reference Cohade C, Mourtzikos KA, Wahl RL (2003) ‘USA-fat’: prevalence is related to ambient outdoor temperature-evaluation with 18F-FDG PET/CT. J Nucl Med 44:1267–1270PubMed Cohade C, Mourtzikos KA, Wahl RL (2003) ‘USA-fat’: prevalence is related to ambient outdoor temperature-evaluation with 18F-FDG PET/CT. J Nucl Med 44:1267–1270PubMed
29.
go back to reference Kim S, Krynyckyi BR, Machac J et al (2008) Temporal relation between temperature change and FDG uptake in brown adipose tissue. Eur J Nucl Med Mol Imaging 35:984–989PubMedCrossRef Kim S, Krynyckyi BR, Machac J et al (2008) Temporal relation between temperature change and FDG uptake in brown adipose tissue. Eur J Nucl Med Mol Imaging 35:984–989PubMedCrossRef
30.
go back to reference Zukotynski KA, Fahey FH, Laffin S et al (2010) Seasonal variation in the effect of constant ambient temperature of 24°C in reducing FDG uptake by brown adipose tissue in children. Eur J Nucl Med Mol Imaging 37:1854–1860PubMedCrossRef Zukotynski KA, Fahey FH, Laffin S et al (2010) Seasonal variation in the effect of constant ambient temperature of 24°C in reducing FDG uptake by brown adipose tissue in children. Eur J Nucl Med Mol Imaging 37:1854–1860PubMedCrossRef
31.
go back to reference Christensen CR, Clark PB, Morton KA (2006) Reversal of hypermetabolic brown adipose tissue in F-18 FDG PET imaging. Clin Nucl Med 31:193–196PubMedCrossRef Christensen CR, Clark PB, Morton KA (2006) Reversal of hypermetabolic brown adipose tissue in F-18 FDG PET imaging. Clin Nucl Med 31:193–196PubMedCrossRef
32.
go back to reference Bar-Sever Z, Keidar Z, Ben-Barak A et al (2007) The incremental value of 18F-FDG PET/CT in paediatric malignancies. Eur J Nucl Med Mol Imaging 34:630–637PubMedCrossRef Bar-Sever Z, Keidar Z, Ben-Barak A et al (2007) The incremental value of 18F-FDG PET/CT in paediatric malignancies. Eur J Nucl Med Mol Imaging 34:630–637PubMedCrossRef
33.
go back to reference Parysow O, Mollerach AM, Jager V et al (2007) Low-dose oral propranolol could reduce brown adipose tissue F-18 FDG uptake in patients undergoing PET scans. Clin Nucl Med 32:351–357PubMedCrossRef Parysow O, Mollerach AM, Jager V et al (2007) Low-dose oral propranolol could reduce brown adipose tissue F-18 FDG uptake in patients undergoing PET scans. Clin Nucl Med 32:351–357PubMedCrossRef
34.
go back to reference Sturkenboom MG, Hoekstra OS, Postema EJ et al (2009) A randomised controlled trial assessing the effect of oral diazepam on 18F-FDG uptake in the neck and upper chest region. Mol Imaging Biol 11:364–368PubMedCrossRef Sturkenboom MG, Hoekstra OS, Postema EJ et al (2009) A randomised controlled trial assessing the effect of oral diazepam on 18F-FDG uptake in the neck and upper chest region. Mol Imaging Biol 11:364–368PubMedCrossRef
35.
go back to reference Williams G, Kolodny GM (2008) Method for decreasing uptake of 18F-FDG by hypermetabolic brown adipose tissue on PET. AJR 190:1406–1409PubMedCrossRef Williams G, Kolodny GM (2008) Method for decreasing uptake of 18F-FDG by hypermetabolic brown adipose tissue on PET. AJR 190:1406–1409PubMedCrossRef
Metadata
Title
Brown adipose tissue 18F-FDG uptake in pediatric PET/CT imaging
Authors
Terence S. Hong
Amer Shammas
Martin Charron
Katherine A. Zukotynski
Laura A. Drubach
Ruth Lim
Publication date
01-06-2011
Publisher
Springer-Verlag
Published in
Pediatric Radiology / Issue 6/2011
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-010-1925-y

Other articles of this Issue 6/2011

Pediatric Radiology 6/2011 Go to the issue