Date: 19 Mar 2008

Optimizing interventions for preventing uptake in the brown adipose tissue in FDG-PET

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With the increasing use of 18-fluoro-deoxy-glucose-positron emission tomography (FDG-PET) in the practice of medicine, enhanced glycolysis in brown adipose tissue (BAT) has posed a major concern for accurate interpretation of the images [1, 2]. Brown fat is a sub-type of adipose tissue and regulates body temperature by non-shivering thermogenesis. This has been termed “USA Fat” by some investigators [2]. Histologically, it is characterized by high vascularity, dense mitochondria in the cells, and abundant sympathetic noradrenergic innervation. The usual distribution of BAT includes neck and shoulder region, axillae, mediastinum, retrocrural and paravertebral sites [14]. FDG uptake in BAT has been noted to occur more frequently in cold months [5]. Recent data suggests that FDG uptake in BAT occurs more often as a result of acute response to cold weather rather than the prolonged periods of average cold weather [6]. Significant localization of FDG in BAT has been particularly problemati ...