Human brown adipose tissue (BAT) has been detected in adults but was recently suggested to be of brite/beige origin. We collected BAT from the supraclavicular region in 21 patients undergoing surgery for suspected cancer in the neck area and assessed the gene expression of established murine markers for brown, brite/beige, and white adipocytes. We demonstrate that a classical brown expression signature, including upregulation of miR-206, miR-133b, LHX8, and ZIC1 and downregulation of HOXC8 and HOXC9, coexists with an upregulation of two newly established brite/beige markers, TBX1 and TMEM26. A similar mRNA expression profile was observed when comparing isolated human adipocytes from BAT and white adipose tissue (WAT) depots, differentiated in vitro. In conclusion, our data suggest that human BAT might consist of both classical brown and recruitable brite adipocytes, an observation important for future considerations on how to induce human BAT.
The use of PET-CT for preoperative staging of NSCLC reduced both the total number of thoracotomies and the number of futile thoracotomies but did not affect overall mortality. (ClinicalTrials.gov number, NCT00867412.)
Functional techniques are playing a pivotal role in the imaging of cancer today. Our aim was to compare, on a head-to-head basis, 3 functional imaging techniques in patients with histologically verified neuroendocrine tumors: somatostatin receptor scintigraphy (SRS) with 111 In-diethylenetriaminepentaacetic acidoctreotide, scintigraphy with 123 I-metaiodobenzylguanidine (MIBG), and 18 F-FDG PET. Methods: Ninety-six prospectively enrolled patients with neuroendocrine tumors underwent SRS, 123 I-MIBG scintigraphy, and 18 F-FDG PET on average within 40 d. The functional images were fused with low-dose CT scans for anatomic localization, and the imaging results were compared with the proliferation index as determined by Ki67. Results: The overall sensitivity of SRS, 123 I-MIBG scintigraphy, and 18 F-FDG PET was 89%, 52%, and 58%, respectively. Of the 11 SRS-negative patients, 7 were 18 F-FDG PET-positive, of which 3 were also 123 I-MIBG scintigraphypositive, giving a combined overall sensitivity of 96%. SRS also exceeded 123 I-MIBG scintigraphy and 18 F-FDG PET based on the number of lesions detected (393, 185, and 225, respectively) and tumor subtypes. 123 I-MIBG scintigraphy was superior to 18 F-FDG PET for ileal neuroendocrine tumors, and 18 F-FDG PET was superior to 123 I-MIBG scintigraphy for pancreaticoduodenal neuroendocrine tumors. The sensitivity of 18 F-FDG PET (92%) exceeded that of both SRS (69%) and 123 I-MIBG scintigraphy (46%) for tumors with a proliferation index above 15%. Conclusion: The overall sensitivity of 123 I-MIBG scintigraphy and 18 F-FDG PET was low compared with SRS. However, for tumors with a high proliferation rate, 18 F-FDG PET had the highest sensitivity. The results indicate that, although SRS should still be the routine method, 18 F-FDG PET provides complementary diagnostic information and is of value for neuroendocrine tumor patients with negative SRS findings or a high proliferation index.
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