Top

European Journal of Nuclear Medicine and Molecular Imaging

Published in:

01-07-2006 | Original article

Brown fat in breast cancer patients: analysis of serial ¹⁸F-FDG PET/CT scans

Authors: C. Rousseau, E. Bourbouloux, L. Campion, N. Fleury, B. Bridji, J. F. Chatal, I. Resche, M. Campone

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 7/2006

Abstract

Purpose

It has recently been suggested that FDG accumulation in the brown adipose tissue varies as a function of age, sex and outdoor temperature. The aim of this study was to assess changes in FDG uptake in brown fat in patients based on serial PET/CT scans and to compare our results with previous findings.

Methods

Early response to neoadjuvant chemotherapy in 33 female breast cancer patients was assessed by FDG PET. Five PET/CT scans were performed for each patient. PET/CT images were analysed retrospectively. PET scans were considered positive when diffuse, symmetrical, abnormal “USA” (uptake in supraclavicular area) fat was detected.

Results

A total of 163 PET images were analysed. Seventy-four PET scans (45%) revealed abnormal FDG uptake in the supraclavicular area. These foci were present on uncorrected and attenuation-corrected images. FDG uptake was identical on all five scans in only five patients. No significant relationship was found between abnormal FDG uptake and outdoor temperature, age or time interval between chemotherapy and PET. Abnormal FDG uptake in the neck seemed to predominantly occur in patients with a low body mass index (p<0.05). Most significant changes in the PET/CT scan results were observed during chemotherapy with docetaxel (p<0.05). When observed, bilateral uptake in the neck was more intense than background uptake (p<0.00001).

Conclusion

This study shows that FDG uptake in the neck varies as a function of time, that it is unrelated to age or outdoor temperature, and that bilateral uptake is generally intense.

Cook GJ, Fogelman I, Maisey MN. Normal physiological and benign pathological variants of 18-fluoro-2-deoxyglucose positron-emission tomography scanning: potential for error in interpretation. Semin Nucl Med 1996;26:308–314PubMedCrossRef

Cohade C, Osman M, Pannu HK, Wahl RL.Uptake in supraclavicular area fat (“USA-fat”): description on¹⁸F-FDG PET/CT. J Nucl Med 2003;44:170–176PubMed

Cohade C, Mourtzikos KA, Wahl RL. “USA-FAT”: prevalence is related to ambient outdoor temperature-evaluation with¹⁸F-FDG PET/CT. J Nucl Med 2003;44:1267–1270PubMed

Barrington SF, Maisey MN. Skeletal muscle uptake of fluorine-18-FDG: effect of oral diazepam. J Nucl Med 1996;37:1127–1129PubMed

Yeung HWD, Grewal RK, Gonen M, Schöder H, Larson SM. Patterns of¹⁸F-FDG uptake in adipose tissue and muscle: a potential source of false-positives for PET. J Nucl Med 2003;44:1789–1796PubMed

Truong MT, Erasmus JJ, Munden RF, Marom EM, Sabloff BS, Gladish GW, et al. Focal FDG uptake in mediastinal brown fat mimicking malignancy: a potential pitfall resolved on PET/CT. AJR 2004;183:1127–1132PubMed

Hany TF, Gharehpapagh E, Kamel EM, Buck A, Himms-Hagen J, Von Schulthess GK. Brown adipose tissue: a factor to consider in symmetrical tracer uptake in the neck and upper chest region. Eur J Nucl Med Mol Imaging 2002;29:1393–1398CrossRefPubMed

Engel H, Steinert H, Buck A, Bethold T, Huch Boni RA, Von Schulthess GK. Whole body PET: physiological and artifactual fluorodeoxyglucose accumulations. J Nucl Med 1996;37:441–446PubMed

Tatsumi M, Engles JM, Ishimori T, Nicely OB, Cohade C, Wahl RL. Intense¹⁸F-FDG uptake in brown fat can be reduced pharmacologically. J Nucl Med 2004;45:1189–1193PubMed

10.

Rodriguez-Cuenca S, Monjo M, Roca P, Palou A. Opposite actions of testosterone and progesterone on UCP1 mRNA expression in cultured brown adipocytes. Cell Mol Life Sci 2002;59:1714–1723CrossRefPubMed

11.

Bartness TJ, Wade GN. Effects of interscapular brown adipose tissue denervation on body weight and energy metabolism in ovariectomized and estradiol-treated rats. Behav Neurosci 1984;98:674–685CrossRefPubMed

12.

Abelenda M, Castro C, Venero C, Puerta M. Reduced oxygen consumption of brown adipocytes isolated from progesterone-treated rats. Can J Physiol Pharmacol 1994;72:1226–1230PubMed

13.

Monjo M, Rodriguez AM, Palou A, Roca P. Direct effects of testosterone, 17β-estradiol, and progesterone on adrenergic regulation in cultured brown adipocytes: potential mechanism for gender-dependent thermogenesis. Endocrinology 2003;144:923–4930CrossRefPubMed

14.

Cannon B, Nedergaard J. Brown adipose tissue: function and physiological significance. Physiol Rev 2004;84:277–359CrossRefPubMed

15.

Bar-Shalom R, Gaitini D, Keidar Z, Israel O. Non-malignant FDG uptake in infradiaphragmatic adipose tissue: a new site of physiological tracer biodistribution characterised by PET/CT. Eur J Nucl Med Mol Imaging 2004;31:1105–1113CrossRefPubMed

16.

Dobert N, Menzel C, Hamscho N, Wordehoff W, Kranert WT, Grundwald F. Atypical thoracic and supraclavicular FDg-uptake in patient with Hodgkin’s and non-Hodgkin’s lymphoma. Q J Nucl Med Mol Imaging 2004;48:33–38PubMed

17.

Fukuchi K, Ono Y, Nakahata Y, Okada Y, Hayashida K, Ishida Y. Visualization of interscapular brown adipose tissue using^99mTc-Tetrofosmin in pediatric patients. J Nucl Med 2003;44:1582–1585PubMed

18.

Okuyama C, Sakane N, Yoshida T, Shima K, Kurosawa H, Kumamoto K, et al.¹²³I- or¹²⁵I-metaiodobenzylguanidine visualization of brown adipose tissue. J Nucl Med 2002;43:1234–1240PubMed

19.

Weber WA. Brown adipose tissue and nuclear medicine. J Nucl Med 2004;45:1101–1103PubMed

20.

Smith IC, Heys SD, Hutcheon AW, Miller ID, Payne S, Gilbert FJ, et al. Neoadjuvant chemotherapy in breast cancer: significantly enhanced response with docetaxel. J Clin Oncol 2002;20:1456–1466CrossRefPubMed

21.

Santos GC, Araujo MR, Silveira TC, Soares FA. Accumulation of brown adipose tissue and nutritional status. A prospective study of 366 consecutive autopsies. Arch Pathol Lab Med 1992;116:1152–1154PubMed

22.

Coombes RC, Rothwell NJ, Shah P, Stock MJ. Changes in thermogenesis and brown fat activity in response to tumour necrosis factor in the rat. Biosci Rep 1987;7:791–799CrossRefPubMed

23.

Garcia CA, Van Nostrand D, Majd M, Atkins F, Acio E, Sheikh A, et al. Benzodiazepine-resistant “brown fat” pattern in positron emission tomography: two case reports of resolution with temperature control. Mol Imaging Biol 2004;6:368–372CrossRefPubMed

24.

Himms-Hagen J. Thermogenesis in brown adipose tissue as an energy buffer. Implications for obesity. N Engl J Med 1984;311:1549–1558PubMedCrossRef

Title: Brown fat in breast cancer patients: analysis of serial 18F-FDG PET/CT scans
Authors: C. Rousseau
E. Bourbouloux
L. Campion
N. Fleury
B. Bridji
J. F. Chatal
I. Resche
M. Campone
Publication date: 01-07-2006
Publisher: Springer-Verlag
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 7/2006
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-006-0066-x

At a glance: The STEP trials

Springer Medicine

Brown fat in breast cancer patients: analysis of serial ¹⁸F-FDG PET/CT scans

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 7/2006

The role of FDG-PET/CT in the detection of recurrent colorectal cancer

Serial O-(2-[18F]fluoroethyl)-L-tyrosine PET for monitoring the effects of intracavitary radioimmunotherapy in patients with malignant glioma

Bilateral adrenal metastases from malignant melanoma: concordant findings on 18F-FDG and 18F-FDOPA PET

Comparison of the diagnostic performance of FDG-PET and VBM-MRI in very mild Alzheimer’s disease

Peripheral benzodiazepine receptors in the brain of cirrhosis patients with manifest hepatic encephalopathy

Submillimetre spatial resolution is feasible in positron emission tomography