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Reduction of FDG uptake in brown adipose tissue in clinical patients by a single dose of propranolol

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Uptake in brown adipose tissue (hibernating fat) is sometimes seen at FDG-PET examinations. Despite a characteristic appearance, this may hide clinically relevant uptake. Stimulation of the sympathetic nervous system increases glucose uptake of brown fat. We now re-examine patients with brown fat activity that could disguise tumour uptake after pre-treatment with propranolol (a non-selective β-blocker) in order to reduce the uptake. Our first examinations of this kind are reported.

Methods

Eleven patients with strong brown fat uptake were studied. There was a mean of 5 days (range 2–8) between the examinations. At the second examination, 80 mg of propranolol was given orally 2 h before FDG administration. In addition to visual evaluation of the brown fat uptake, SUV assessments of the uptake in brown fat, lung, heart, liver, spleen and bone marrow were made.

Results

All patients showed complete or almost complete disappearance of the brown fat activity at the second examination (p < 0.001) both upon visual evaluation and when comparing SUVs. In seven patients there was also uptake in a known or strongly suspected malignancy, which remained unchanged between the examinations. Beyond an insignificant decrease in the myocardial uptake, there was no redistribution to the various examined organs at the second examination.

Conclusion

Pre-treatment with a single dose of propranolol blocks the FDG uptake in brown adipose tissue, thereby increasing the specificity of the examination. The tumour uptake seems not to be impaired.

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References

  1. Jacobsson H, Bruzelius M, Larsson SA. Reduction of FDG uptake in brown adipose tissue by propranolol. Eur J Nucl Med Mol Imaging 2005;32:1130.

    Article  PubMed  Google Scholar 

  2. 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;29:1393–8.

    Article  PubMed  Google Scholar 

  3. Cohade C, Osman M, Pannu HK, Wahl RL. Uptake in supraclavicular area fat (“USA-fat”): description on 18F-FDG PET/CT. J Nucl Med 2003;44:170–6.

    PubMed  CAS  Google Scholar 

  4. Yeung HW, Grewal RK, Gonen M, Schöder H, Larson SM. Patterns of 18F-FDG uptake in adipose tissue and muscle: a potential source of false-positives for PET. J Nucl Med 2003;44:1789–96.

    PubMed  Google Scholar 

  5. 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;183:1127–32.

    PubMed  Google Scholar 

  6. Tatsumi M, Engles JM, Ishimori T, Nicely O, Cohade C, Wahl RL. Intense 18F-FDG uptake in brown fat can be reduced pharmacologically. J Nucl Med 2004;45:1189–93.

    PubMed  CAS  Google Scholar 

  7. Cook GJR, 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;26:308–14.

    Article  PubMed  CAS  Google Scholar 

  8. Barrington SF, Maisey MN. Skeletal muscle uptake of fluorine-18-FDG: effect of oral diazepam. J Nucl Med 1996;37:1127–9.

    PubMed  CAS  Google Scholar 

  9. Christensen CR, Clark PB, Morton KA. Reversal of hypermetabolic brown adipose tissue on FDG PET [abstract]. J Nucl Med 2005;46(Suppl):S41.

    Google Scholar 

  10. Truong MT, Erasmus JJ, Macapinlac HA, Marom EM, Mawlawi O, Gladish GW, et al. Integrated positron emission tomography/computed tomography in patients with non-small cell lung cancer. Normal variants and pitfalls. J Comput Assist Tomogr 2005;29:205–9.

    Article  PubMed  Google Scholar 

  11. Hull D, Segall M. Sympathetic nervous control of brown adipose tissue and heat production in the new-born rabbit. J Physiol 1965;181:458–67.

    PubMed  CAS  Google Scholar 

  12. Cohade C, Mourtzikos KA, Wahl RL. “USA-fat”: prevalence is related to ambient outdoor temperature—evaluation with 18F-FDG PET/CT. J Nucl Med 2003;44:1267–70.

    PubMed  Google Scholar 

  13. Rousseau C, Bourbouloux E, Campion L, Fleury N, Bridji B, Chatal JF, et al. Brown fat in breast cancer patients: analysis of serial 18F-FDG PET/CT scans. Eur J Nucl Med Mol Imaging 2006;33:785–91.

    Article  PubMed  CAS  Google Scholar 

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Acknowledgements

Advice from Dr. Hans Johnsson, Department of Internal Medicine, Karolinska University Hospital and the statistical analysis by Elisabeth Berg, BSc, Medical Statistics Unit, Karolinska Institute, are greatly appreciated.

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Correspondence to Veli Söderlund.

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Söderlund, V., Larsson, S.A. & Jacobsson, H. Reduction of FDG uptake in brown adipose tissue in clinical patients by a single dose of propranolol. Eur J Nucl Med Mol Imaging 34, 1018–1022 (2007). https://doi.org/10.1007/s00259-006-0318-9

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  • DOI: https://doi.org/10.1007/s00259-006-0318-9

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