Key result
Overall, 27.0% of patients evaluated for pheochromocytoma showed brown adipose tissue uptake on at least one of the three imaging modalities (18F-F-DA, 18F-FDG, or 123I-MIBG).
Why the study?
Can 18F-6-fluorodopamine PET/CT, 18F-FDG PET/CT, and 123I-MIBG SPECT detect brown adipose tissue in patients evaluated for pheochromocytoma?
Observational (n=96)
Can 18F-6-fluorodopamine PET/CT, 18F-FDG PET/CT, and 123I-MIBG SPECT detect brown adipose tissue in patients evaluated for pheochromocytoma?
18F-F-DA can image brown adipose tissue, likely by localizing to sympathetic innervations, which is important to recognize as a normal variant to avoid misinterpretation in patients evaluated for pheochromocytoma.
Recognizing BAT uptake on these tracers may prevent misinterpretation in pheochromocytoma evaluation; leaves open dedicated validation for BAT imaging.
UNLABELLED: Several radiopharmaceuticals such as (18)F-FDG, (123)I-metaiodobenzylguanidine (MIBG), and (99m)Tc-tetrofosmin have demonstrated uptake in brown adipose tissue (BAT). It is important to recognize these normal variants so that they are not misinterpreted as a significant pathologic state. In addition, these radiopharmaceuticals may shed light on BAT physiology. (18)F-6-fluorodopamine (F-DA) is being used as a PET radiopharmaceutical to image adrenergic innervation and suspected pheochromocytoma. Past reports have suggested that BAT is increased in pheochromocytoma patients. METHODS: The images of 96 patients evaluated with (18)F-F-DA or (18)F-FDG PET/CT for known or suspected pheochromocytoma were reviewed retrospectively to determine whether localized uptake of a pattern typically associated with BAT was present. When available, contemporaneous images obtained using (123)I-MIBG were also reviewed for the presence of BAT. RESULTS: Of 67 patients imaged with (18)F-F-DA, BAT was found in 17.9%. Of 83 patients imaged with (18)F-FDG, 19.2% had BAT. Discordant findings related to uptake in BAT were often seen in patients studied with (18)F-FDG, (18)F-F-DA, or (123)I-MIBG. Overall, 26 (27.0%) of 96 patients showed BAT on at least 1 of the 3 imaging modalities. CONCLUSION: (18)F-F-DA can image BAT, most likely by localizing to sympathetic innervations in a manner similar to (123)I-MIBG. Patients with pheochromocytoma may have a greater BAT tissue mass or activation because of elevated levels of circulating catecholamines. Quantitative PET with (18)F-FDG and (18)F-F-DA may have a role in in vivo studies of BAT physiology in humans or animal models.
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Hadi et al. (2007) conducted an observational in Known or suspected pheochromocytoma (n=96). 18F-F-DA, 18F-FDG, and 123I-MIBG imaging was evaluated on Presence of localized uptake associated with brown adipose tissue (BAT). Overall, 27.0% of patients evaluated for pheochromocytoma showed brown adipose tissue uptake on at least one of the three imaging modalities (18F-F-DA, 18F-FDG, or 123I-MIBG).
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