Seminars in Nuclear Medicine
Volume 40, Issue 4 , Pages 283-293 , July 2010

Altered Biodistribution on FDG-PET with Emphasis on Brown Fat and Insulin Effect

  • Christian Cohade, MD, FRCP(C), ABNM

      Affiliations

    • Corresponding Author InformationAddress reprint requests to Christian Cohade, MD, FRCP(C), ABNM, Department of Nuclear Medicine, Centre Hospitalier de l'Université de Montréal, 3840 St-Urbain, Montréal, Québec, Canada, H2W 1T8

References 

  1. Barrington SF, Maisey MN. Skeletal muscle uptake of fluorine-18-FDG: Effect of oral diazepam. J Nucl Med. 1996;37:1127–1129
  2. Bar-Shalom R. Muscle uptake of 18-fluorine fluorodeoxyglucose. Semin Nucl Med. 2000;30:306–309
  3. Lindholm P, Minn H, Leskinen-Kallio S, et al. Influence of the blood glucose concentration on FDG uptake in cancer—A PET study. J Nucl Med. 1993;34:1–6
  4. Torizuka T, Zasadny KR, Wahl RL. Diabetes decreases FDG accumulation in primary lung cancer. Clin Positron Imaging. 1999;2:281–287
  5. Diederichs CG, Staib L, Glatting G, et al. FDG PET: Elevated plasma glucose reduces both uptake and detection rate of pancreatic malignancies. J Nucl Med. 1998;39:1030–1033
  6. Gorenberg M, Hallett WA, O'Doherty MJ. Does diabetes affect [(18)F]FDG standardised uptake values in lung cancer?. Eur J Nucl Med Mol Imaging. 2002;29:1324–1327
  7. Chang YC, Yen TC, Ng KK, et al. Does diabetes mellitus influence the efficacy of FDG-PET in the diagnosis of cervical cancer?. Eur J Nucl Med Mol Imaging. 2005;32:647–652
  8. Hara T, Higashi T, Nakamoto Y, et al. Significance of chronic marked hyperglycemia on FDG-PET: Is it really problematic for clinical oncologic imaging?. Ann Nucl Med. 2009;23:657–669
  9. Torizuka T, Clavo AC, Wahl RL. Effect of hyperglycemia on in vitro tumor uptake of tritiated FDG, thymidine, L-methionine and L-leucine. J Nucl Med. 1997;38:382–386
  10. Delbeke D, Coleman RE, Guiberteau MJ, et al. Procedure guideline for tumor imaging with 18F-FDG PET/CT 1.0. J Nucl Med. 2006;47:885–895
  11. Varrone A, Asenbaum S, Vander Borght T, et al. EANM procedure guidelines for PET brain imaging using [(18)F]FDG, version 2. Eur J Nucl Med Mol Imaging. 2009;36:2103–2110
  12. Turcotte E, Leblanc M, Carpentier A, et al. Optimization of whole-body positron emission tomography imaging by using delayed 2-deoxy-2-[F-18]fluoro-D-glucose injection following I.V. insulin in diabetic patients. Mol Imaging Biol. 2006;8:348–354
  13. Roy FN, Beaulieu S, Boucher L, et al. Impact of intravenous insulin on 18F-FDG PET in diabetic cancer patients. J Nucl Med. 2009;50:178–183
  14. Niederkohr RD, Quon A. No apparent alteration of F-18 FDG biodistribution when injected shortly after insulin glargine. Clin Nucl Med. 2007;32:302–303
  15. Virtanen KA, Lonnroth P, Parkkola R, et al. Glucose uptake and perfusion in subcutaneous and visceral adipose tissue during insulin stimulation in nonobese and obese humans. J Clin Endocrinol Metab. 2002;87:3902–3910
  16. Viljanen AP, Virtanen KA, Jarvisalo MJ, et al. Rosiglitazone treatment increases subcutaneous adipose tissue glucose uptake in parallel with perfusion in patients with type 2 diabetes: A double-blind, randomized study with metformin. J Clin Endocrinol Metab. 2005;90:6523–6528
  17. Hany TF, Gharehpapagh E, Kamel EM, et al. 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
  18. Cohade C, Osman M, Pannu HK, et al. Uptake in supraclavicular area fat (“US-Fat”): Description on 18F-FDG PET/CT. J Nucl Med. 2003;44:170–176
  19. Huttunen P, Hirvonen J, Kinnula V. The occurrence of brown adipose tissue in outdoor workers. Eur J Appl Physiol Occup Physiol. 1981;46:339–345
  20. Tatsumi M, Engles JM, Ishimori T, et al. Intense (18)F-FDG uptake in brown fat can be reduced pharmacologically. J Nucl Med. 2004;45:1189–1193
  21. Belhocine T, Shastry A, Driedger A, et al. Detection of 99mTc-sestamibi uptake in brown adipose tissue with SPECT-CT. Eur J Nucl Med Mol Imaging. 2007;34:149
  22. Gelfand MJ. 123I-mIBG uptake in the neck and shoulders of a neuroblastoma patient: Damage to sympathetic innervation blocks uptake in brown adipose tissue. Pediatr Radiol. 2004;34:577–579
  23. Hadi M, Chen CC, Whatley M, et al. Brown fat imaging with (18)F-6-fluorodopamine PET/CT, (18)F-FDG PET/CT, and (123)I-mIBG SPECT: A study of patients being evaluated for pheochromocytoma. J Nucl Med. 2007;48:1077–1083
  24. Higuchi T, Kinuya S, Taki J, et al. Brown adipose tissue: Evaluation with 201Tl and 99mTc-sestamibi dual-tracer SPECT. Ann Nucl Med. 2004;18:547–549
  25. Kyparos D, Arsos G, Georga S, et al. Assessment of brown adipose tissue activity in rats by 99mTc-sestamibi uptake. Physiol Rev. 2006;55:653–659
  26. Virtanen KA, Lidell ME, Orava J, et al. Functional brown adipose tissue in healthy adults. N Engl J Med. 2009;360:1518–1525
  27. Lowell BB, Spiegelman BM. Towards a molecular understanding of adaptive thermogenesis. Nature. 2000;404:652–660
  28. Nedergaard J, Bengtsson T, Cannon B. Unexpected evidence for active brown adipose tissue in adult humans. Am J Physiol Endocrinol Metab. 2007;293:E444–E452
  29. Ma SW. Foster DO uptake of glucose and release of fatty acids and glycerol by rat brown adipose tissue in vivo. Can J Physiol Pharmacol. 1986;64:609–614
  30. Cannon B, Nedergaard J. Brown adipose tissue: Function and physiological significance. Physiol Rev. 2004;84:277–359
  31. Cohade C, Mourtzikos KA, Wahl RL. “US-Fat”: Prevalence is related to ambient outdoor temperature-evaluation with 18F-FDG PET/CT. J Nucl Med. 2003;44:1267–1270
  32. Rousseau C, Bourbouloux E, Campion L, et al. Brown fat in breast cancer patients: Analysis of serial (18)F-FDG PET/CT scans. Eur J Nucl Med Mol Imaging. 2006;33:785–791
  33. Kim S, Krynyckyi BR, Machac J, et al. Temporal relation between temperature change and FDG uptake in brown adipose tissue. Eur J Nucl Med Mol Imaging. 2008;35:984–989
  34. Saito M, Okamatsu-Ogura Y, Matsushita M, et al. High incidence of metabolically active brown adipose tissue in healthy adult humans: Effects of cold exposure and adiposity. Diabetes. 2009;58:1526–1531
  35. Au-Yong IT, Thorn N, Ganatra R, et al. Brown adipose tissue and seasonal variation in humans. Diabetes. 2009;58:2583–2587
  36. McDonald RB, Murtagh CM, Horwitz BA. Age and gender effects on glucose utilization in skeletal muscle and brown adipose tissue of cold-exposed rats. Proc Soc Exp Biol Med. 1994;207:102–109
  37. Yeung HW, Grewal RK, Gonen M, et al. Patterns of (18)F-FDG uptake in adipose tissue and muscle: A potential source of false-positives for PET. J Nucl Med. 2003;44:1789–1796
  38. Gelfand MJ, O'Hara SM, Curtwright LA, et al. Pre-medication to block [(18)F]FDG uptake in the brown adipose tissue of pediatric and adolescent patients. Pediatr Radiol. 2005;35:984–990
  39. van Marken Lichtenbelt WD, Vanhommerig JW, Smulders NM, et al. Cold-activated brown adipose tissue in healthy men. N Engl J Med. 2009;360:1500–1508
  40. Iyer RB, Guo CC, Perrier N. Adrenal pheochromocytoma with surrounding brown fat stimulation. AJR Am J Roentgenol. 2009;192:300–301
  41. Bar-Shalom R, Gaitini D, Keidar Z, et al. 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
  42. Truong MT, Erasmus JJ, Munden RF, et al. Focal FDG uptake in mediastinal brown fat mimicking malignancy: A potential pitfall resolved on PET/CT. AJR Am J Roentgenol. 2004;183:1127–1132
  43. Fan CM, Fischman AJ, Kwek BH, et al. Lipomatous hypertrophy of the interatrial septum: Increased uptake on FDG PET. AJR Am J Roentgenol. 2005;184:339–342
  44. Kuester LB, Fischman AJ, Fan CM, et al. Lipomatous hypertrophy of the interatrial septum: Prevalence and features on fusion 18F fluorodeoxyglucose positron emission tomography/CT. Chest. 2005;128:3888–3893
  45. Hoffmann C, Leitz MR, Oberdorf-Maass S, et al. Comparative pharmacology of human beta-adrenergic receptor subtypes—Characterization of stably transfected receptors in CHO cells. Naunyn Schmiedebergs Arch Pharmacol. 2004;369:151–159
  46. Soderlund V, Larsson SA, 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. 2007;34:1018–1022
  47. Parysow O, Mollerach AM, Jager V, et al. Low-dose oral propranolol could reduce brown adipose tissue F-18 FDG uptake in patients undergoing PET scans. Clin Nucl Med. 2007;32:351–357
  48. Agrawal A, Nair N, Baghel NS. A novel approach for reduction of brown fat uptake on FDG PET. Br J Radiol. 2009;82:626–631
  49. Hirsch JD. Pharmacological and physiological properties of benzodiazepine binding sites in rodent brown adipose tissue (Comp Biochem). Physiologist C. 1984;77:339–343
  50. Sturkenboom MG, Hoekstra OS, Postema EJ, et al. A randomised controlled trial assessing the effect of oral diazepam on 18F-FDG uptake in the neck and upper chest region. Mol Imaging Biol. 2009;11:364–368
  51. Baba S, Tatsumi M, Ishimori T, et al. Effect of nicotine and ephedrine on the accumulation of 18F-FDG in brown adipose tissue. J Nucl Med. 2007;48:981–986
  52. Williams G, Kolodny GM. Method for decreasing uptake of 18F-FDG by hypermetabolic brown adipose tissue on PET. AJR Am J Roentgenol. 2008;190:1406–1409
  53. Williams G, Kolodny GM. Suppression of myocardial 18F-FDG uptake by preparing patients with a high-fat, low-carbohydrate diet. AJR Am J Roentgenol. 2008;190:W151–W156
  54. Garcia CA, Van Nostrand D, Atkins F, et al. Reduction of brown fat 2-deoxy-2-[F-18]fluoro-d-glucose uptake by controlling environmental temperature prior to positron emission tomography scan. Mol Imaging Biol. 2006;8:24–29
  55. Zukotynski KA, Fahey FH, Laffin S, et al. Constant ambient temperature of 24 degrees C significantly reduces FDG uptake by brown adipose tissue in children scanned during the winter. Eur J Nucl Med Mol Imaging. 2009;36:602–606
  56. Skarulis MC, Celi FS, Mueller E, et al. Thyroid hormone induced brown adipose tissue and amelioration of diabetes in a patient with extreme insulin resistance. J Clin Endocrinol Metab. 2010;95:256–262
  57. Sugawara Y, Fisher SJ, Zasadny KR, et al. Preclinical and clinical studies of bone marrow uptake of fluorine-1-fluorodeoxyglucose with or without granulocyte colony-stimulating factor during chemotherapy. J Clin Oncol. 1998;16:173–180
  58. Sugawara Y, Zasadny KR, Kison PV, et al. Splenic fluorodeoxyglucose uptake increased by granulocyte colony-stimulating factor therapy: PET imaging results. J Nucl Med. 1999;40:1456–1462
  59. Hollinger EF, Alibazoglu H, Ali A, et al. Hematopoietic cytokine-mediated FDG uptake simulates the appearance of diffuse metastatic disease on whole-body PET imaging. Clin Nucl Med. 1998;23:93–98
  60. Kazama T, Swanston N, Podoloff DA, et al. Effect of colony-stimulating factor and conventional- or high-dose chemotherapy on FDG uptake in bone marrow. Eur J Nucl Med Mol Imaging. 2005;32:1406–1411
  61. Jacene HA, Ishimori T, Engles JM, et al. Effects of pegfilgrastim on normal biodistribution of 18F-FDG: Preclinical and clinical studies. J Nucl Med. 2006;47:950–956
  62. Goethals I, Hoste P, De Vriendt C, et al. Time-dependent changes in (18)F-FDG activity in the thymus and bone marrow following combination chemotherapy in paediatric patients with lymphoma. Eur J Nucl Med Mol Imaging. 2010;37:462–467
  63. Plantade A, Montravers F, Selle F, et al. Diffusely increased F-18 FDG uptake in bone marrow in a patient with acute anemia and recent erythropoietin therapy. Clin Nucl Med. 2003;28:771–772
  64. Blodgett TM, Ames JT, Torok FS, et al. Diffuse bone marrow uptake on whole-body F-18 fluorodeoxyglucose positron emission tomography in a patient taking recombinant erythropoietin. Clin Nucl Med. 2004;29:161–163
  65. Prevost S, Boucher L, Larivee P, et al. Bone marrow hypermetabolism on 18F-FDG PET as a survival prognostic factor in non-small cell lung cancer. J Nucl Med. 2006;47:559–565
  66. Van de Wiele C, Vandevyver F, Debruyne C, et al. FDG uptake by the bone marrow in NSCLC patients is related to TGF-beta but not to VEGF or G-CSF serum levels. Eur J Nucl Med Mol Imaging. 2008;35:519–522
  67. Gontier E, Fourme E, Wartski M, et al. High and typical 18F-FDG bowel uptake in patients treated with metformin. Eur J Nucl Med Mol Imaging. 2008;35:95–99
  68. Minamimoto R, Takahashi N, Inoue T. FDG-PET of patients with suspected renal failure: Standardized uptake values in normal tissues. Ann Nucl Med. 2007;21:217–222
  69. Laffon E, Cazeau AL, Monet A, et al. The effect of renal failure on 18F-FDG uptake: A theoretic assessment. J Nucl Med Technol. 2008;36:200–202

PII: S0001-2998(10)00004-8

doi: 10.1053/j.semnuclmed.2010.02.001

Seminars in Nuclear Medicine
Volume 40, Issue 4 , Pages 283-293 , July 2010

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