The Relationship between Brown Adipose Tissue Activity and Neoplastic Status: an 18F-FDG PET/CT Study in the Tropics

Abstract Background Accumulating evidence links brown adipose tissue (BAT) to increased cold-induced energy expenditure (CIEE) and regulation of lipid metabolism in humans. BAT has also been proposed as a novel source for biologically active lipid mediators including polyunsaturated fatty acids (PUFAs) and oxylipins. However, little is known about cold-mediated differences in energy expenditure and various lipid species between individuals with detectable BAT positive (BATpos) and those without BAT negative (BATneg). Methods Here we investigated a unique cohort of matched BATpos and BATneg individuals identified by 18F-fluorodeoxyglucose positron emission tomography combined with computed tomography ([18F]-FDG PET/CT). BAT function, CIEE, and circulating oxylipins, were analyzed before and after short-term cold exposure using [18F]-FDG PET/CT, indirect calorimetry, and high-resolution mass spectrometry, respectively. Results We found that active BAT is the major determinant of CIEE since only BATpos individuals experienced significantly increased energy expenditure in response to cold. A single bout of moderate cold exposure resulted in the dissipation of an additional 20 kcal excess energy in BATpos but not in BATneg individuals. The presence of BAT was associated with a unique systemic PUFA and oxylipin profile characterized by increased levels of anti-inflammatory omega-3 fatty acids as well as cytochrome P450 products but decreased concentrations of some proinflammatory hydroxyeicosatetraenoic acids when compared with BATneg individuals. Notably, cold exposure raised circulating levels of various lipids, including the recently identified BAT-derived circulating factors (BATokines) DiHOME and 12-HEPE, only in BATpos individuals. Conclusions In summary, our data emphasize that BAT in humans is a major contributor toward cold-mediated energy dissipation and a critical organ in the regulation of the systemic lipid pool.

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Extensive hypermetabolic pattern of brown adipose tissue activation on 18F-FDG PET/CT in a patient diagnosed of catecholamine-secreting para-vesical paraganglioma

Revista Española de Medicina Nuclear e Imagen Molecular (English Edition) ◽

10.1016/j.remnie.2013.09.011 ◽

2013 ◽

Vol 32 (6) ◽

pp. 397-399

Author(s):

J. Banzo ◽

M.A. Ubieto ◽

M.F. Berisa ◽

A. Andrés ◽

M.L. Mateo ◽

...

Keyword(s):

Adipose Tissue ◽

Brown Adipose Tissue ◽

Fdg Pet ◽

Brown Adipose ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

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Measurement of Brown Adipose Tissue Activity Using Microwave Radiometry and18F-FDG PET/CT

Journal of Nuclear Medicine ◽

10.2967/jnumed.117.204339 ◽

2018 ◽

Vol 59 (8) ◽

pp. 1243-1248 ◽

Cited By ~ 13

Author(s):

John P. Crandall ◽

Joo H. O ◽

Prateek Gajwani ◽

Jeffrey P. Leal ◽

Daniel D. Mawhinney ◽

...

Keyword(s):

Adipose Tissue ◽

Brown Adipose Tissue ◽

Fdg Pet ◽

Microwave Radiometry ◽

Brown Adipose ◽

Pet Ct ◽

Brown Adipose Tissue Activity ◽

Fdg Pet Ct

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Pheochromocytoma and Paraganglioma Patients With Poor Survival Often Show Brown Adipose Tissue Activation

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgz314 ◽

2020 ◽

Vol 105 (4) ◽

pp. 1176-1185

Author(s):

Zahraa Abdul Sater ◽

Abhishek Jha ◽

Ahmed Hamimi ◽

Adel Mandl ◽

Iris R Hartley ◽

...

Keyword(s):

Overall Survival ◽

Adipose Tissue ◽

Brown Adipose Tissue ◽

Fdg Pet ◽

Control Group ◽

Male Body ◽

Brown Adipose ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

Abstract Context Pheochromocytomas/paragangliomas (PPGLs) are neuroendocrine tumors that can secrete norepinephrine (NE). Brown adipose tissue (BAT) activation is mediated through the action of NE on β-adrenoceptors (β-ARs). In some malignancies, BAT activation is associated with higher cancer activity. Objective To study the relationship between BAT activation and PPGL clinical outcomes. Design A retrospective case-control study that included 342 patients with PPGLs who underwent 18F-fluoro-2-deoxy-D-glucose positron emission tomography-computed tomography (18F-FDG PET/CT) imaging at the National Institutes of Health (NIH). We excluded all patients with parasympathetic tumors and those who underwent 18F-FDG PET/CT after PPGL resection. Scans of 205 patients were reviewed by 2 blinded nuclear medicine physicians; 16 patients had BAT activation on 18F-FDG PET/CT [7.80%; age 27.50 (15.00–45.50) years; 10 female/6 male; body mass index [BMI] 24.90 [19.60–25.35] kg/m2). From the remaining 189 patients, we selected 36 matched controls (age 34.4 [25.4–45.5] years; 21 female/15 male; BMI 25.0 [22.0–26.0] kg/m2). Primary Outcome Measure Overall survival. Results The presence of active BAT on 18F-FDG PET/CT was associated with decreased overall survival when compared with the control group (HRz 5.80; 95% CI, 1.05–32.05; P = 0.02). This association remained significant after adjusting for the SDHB mutation. Median plasma NE in the BAT group was higher than the control group [4.65 vs 0.55 times above the upper limit of normal; P < 0.01]. There was a significant association between higher plasma NE levels and mortality in PPGLs in both groups. Conclusions Our findings suggest that the detection of BAT activity in PPGL patients is associated with higher mortality. We suggest that BAT activation could either be reflecting or contributing to a state of increased host stress that may predict poor outcome in metastatic PPGL.

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