Background:18F-FDG PET/CT is an ideal diagnostic tool to investigate the
metabolic activation of brown adipose tissue (BAT); high uptake in BAT
interferes with scan interpretation.
Aim: To evaluate the factors affecting BAT activation on 18F-FDG-PET/CT in
patients with lymphoma.
Methods: 18F-FDG-PET/CT scans of 208 consecutive patients with
pathologically proven lymphoma were retrospectively reviewed PET/CT images
were analyzed visually for the presence of FDG-avid BAT, its site, and its
amount. For each area showing active BAT uptake, the maximum standardized
uptake value (SUVmax) was calculated. In addition, the metabolic volume of
activated BAT for each region was computed, and then the total metabolic
volume (TMV) was recorded.
Results: BAT was activated in 48/208 patients (23.1%), and most of them
(45/48) had bilateral uptake in the supraclavicular regions. BAT activation was
significantly more frequent among younger age groups (P ≤ 0.01), female
gender (P = 0.01), and Hodgkin type (HL) (P < 0.01), but it was insignificantly
more frequent in patients with higher body mass index (BMI) (P = 0.07).
In univariate analysis, the patient’s age, sex, pathological type, injected dose,
uptake period, fasting blood glucose, and outdoor temperature were significantly
associated with BAT activation. Patient’s age (OR = 1.124, P < 0.01) and
outdoor temperature (OR = 1.238, P < 0.01) continued to be significant
independent predictor factors for BAT activation in multivariate regression
analysis.
Conclusion: BAT activation occurs more often in females, younger ages, and
patients with HL. Lower outdoor temperature and younger age are the
independent variables for prediction of BAT activation.
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