FDG uptake in brown adipose tissue-a brief report on brown fat with FDG uptake mechanisms and quantitative analysis using dual-time-point FDG PET/CT. 2011

B Esen Akkas, and D Gökaslan, and L Güner, and N Ilgin Karabacak
Ankara Oncology Research and Training Hospital, Department of Nuclear Medicine, Ankara, Turkey. burcuesen@yahoo.com

OBJECTIVE Brown adipose tissue (BAT) is a potential source of false-positive findings on [(18)F] FDG PET. In this report, we have discussed the (18)F-FDG uptake mechanisms in BAT and have aimed to determine if dual time point PET imaging helps to differentiate BAT from malignant lesions. METHODS Patients with dual-time-point PET/CT scans were reviewed retrospectively and 31 cases (11 males, 20 females, age: 28.6±9.7) having hypermetabolic BAT were included for this study. (18)F-FDG uptake in BAT was quantitatively analyzed by maximum standardized uptake values (SUVmax), and average percent change in SUVmax of BAT between early and delayed images was calculated. RESULTS Compared to the initial scans, (18)F-FDG uptakes in BAT in delayed images were higher in 26 of the patients, and lower in one patient. In terms of body regions, (18)F-FDG uptake increased in 80.6%, remained unchanged in 5.5% and decreased in 13.9% of the body regions. Mean percent change in SUVmax, including all BAT regions, was 19.8±19.1% while the mean percent increase was calculated as 69±25% in regions where progressive accumulation was observed. The increase in SUVmax correlated with the time interval between the two scans. CONCLUSIONS Physiologic (18)F-FDG uptake in BAT increases over time and may mimic the behavior of malignant lesions on dual time point PET imaging. Without the exact anatomic definition of the CT scan, false positive interpretation of PET data may be possible in cases with atypical BAT.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009369 Neoplasms New abnormal growth of tissue. Malignant neoplasms show a greater degree of anaplasia and have the properties of invasion and metastasis, compared to benign neoplasms. Benign Neoplasm,Cancer,Malignant Neoplasm,Tumor,Tumors,Benign Neoplasms,Malignancy,Malignant Neoplasms,Neoplasia,Neoplasm,Neoplasms, Benign,Cancers,Malignancies,Neoplasias,Neoplasm, Benign,Neoplasm, Malignant,Neoplasms, Malignant
D009928 Organ Specificity Characteristic restricted to a particular organ of the body, such as a cell type, metabolic response or expression of a particular protein or antigen. Tissue Specificity,Organ Specificities,Specificities, Organ,Specificities, Tissue,Specificity, Organ,Specificity, Tissue,Tissue Specificities
D002001 Adipose Tissue, Brown A thermogenic form of adipose tissue composed of BROWN ADIPOCYTES. It is found in newborns of many species including humans, and in hibernating mammals. Brown fat is richly vascularized, innervated, and densely packed with MITOCHONDRIA which can generate heat directly from the stored lipids. Brown Fat,Hibernating Gland,Brown Adipose Tissue,Fat, Brown,Tissue, Brown Adipose
D003937 Diagnosis, Differential Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures. Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D004734 Energy Metabolism The chemical reactions involved in the production and utilization of various forms of energy in cells. Bioenergetics,Energy Expenditure,Bioenergetic,Energy Expenditures,Energy Metabolisms,Expenditure, Energy,Expenditures, Energy,Metabolism, Energy,Metabolisms, Energy
D005189 False Positive Reactions Positive test results in subjects who do not possess the attribute for which the test is conducted. The labeling of healthy persons as diseased when screening in the detection of disease. (Last, A Dictionary of Epidemiology, 2d ed) False Positive Reaction,Positive Reaction, False,Positive Reactions, False,Reaction, False Positive,Reactions, False Positive
D005260 Female Females
D005462 Fluorine Radioisotopes Unstable isotopes of fluorine that decay or disintegrate emitting radiation. F atoms with atomic weights 17, 18, and 20-22 are radioactive fluorine isotopes. Radioisotopes, Fluorine

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