Skip to main content

Advertisement

Log in

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

  • Original article
  • Published:
European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. 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;26:308–314

    Article  PubMed  CAS  Google Scholar 

  2. 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;44:170–176

    PubMed  CAS  Google Scholar 

  3. 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;44:1267–1270

    PubMed  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  5. Yeung HWD, 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;44:1789–1796

    PubMed  Google Scholar 

  6. 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;183:1127–1132

    PubMed  Google Scholar 

  7. 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;29:1393–1398

    Article  PubMed  Google Scholar 

  8. 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;37:441–446

    PubMed  CAS  Google Scholar 

  9. Tatsumi M, Engles JM, Ishimori T, Nicely OB, Cohade C, Wahl RL. Intense 18F-FDG uptake in brown fat can be reduced pharmacologically. J Nucl Med 2004;45:1189–1193

    PubMed  CAS  Google Scholar 

  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;59:1714–1723

    Article  PubMed  Google Scholar 

  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;98:674–685

    Article  PubMed  CAS  Google Scholar 

  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;72:1226–1230

    PubMed  CAS  Google Scholar 

  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;144:923–4930

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  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;31:1105–1113

    Article  PubMed  CAS  Google Scholar 

  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;48:33–38

    PubMed  CAS  Google Scholar 

  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;44:1582–1585

    PubMed  Google Scholar 

  18. Okuyama C, Sakane N, Yoshida T, Shima K, Kurosawa H, Kumamoto K, et al. 123I- or 125I-metaiodobenzylguanidine visualization of brown adipose tissue. J Nucl Med 2002;43:1234–1240

    PubMed  CAS  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  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;20:1456–1466

    Article  PubMed  CAS  Google Scholar 

  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;116:1152–1154

    PubMed  CAS  Google Scholar 

  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;7:791–799

    Article  PubMed  CAS  Google Scholar 

  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;6:368–372

    Article  PubMed  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to C. Rousseau.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rousseau, C., Bourbouloux, E., Campion, L. et al. Brown fat in breast cancer patients: analysis of serial 18F-FDG PET/CT scans. Eur J Nucl Med Mol Imaging 33, 785–791 (2006). https://doi.org/10.1007/s00259-006-0066-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00259-006-0066-x

Keywords

Navigation