Hypermetabolic Mesenteric Brown Adipose Tissue on Dual-Time Point FDG PET/CT in a Patient With Benign Retroperitoneal Pheochromocytoma

Dong, Aisheng; Wang, Yang; Lu, Jianping; Zuo, Chuantao

doi:10.1097/rlu.0b013e3182816515

Cited by 20 publications

(13 citation statements)

References 9 publications

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“…Furthermore, in patients with retroperitoneal pheochromocytoma, abdominal visceral fat exposed to high noradrenaline concentrations for prolonged durations has shown intense 18 F-FDG uptake (27). These findings suggest that beige adipocytes may be of potential significance in human subjects, as they are in mice.…”

Section: Discussionmentioning

confidence: 69%

¹⁸F-FDG PET/CT Monitoring of β3 Agonist–Stimulated Brown Adipocyte Recruitment in White Adipose Tissue

et al. 2014

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There is rising interest in recruitment of brown adipocytes into white adipose tissue (WAT) as a means to augment energy expenditure for weight reduction. We thus investigated the potential of 18 F-FDG uptake as an imaging biomarker that can monitor the process of WAT browning. Methods: C57BL/6 mice were treated daily with the β3 agonist CL316,243 (5-[(2R)-2-[[(2R)-2-(3-chlorophenyl)-2-hydroxyethyl] amino]propyl]-1,3-benzodioxole-2,2-dicarboxylic acid disodium salt), whereas controls received saline. 18 F-FDG small-animal PET/CT was serially performed at 1 h after CL316,243 injection. After sacrifice, interscapular brown adipose tissue (BAT) and WAT depots were extracted, weighed, and measured for 18 F-FDG uptake. Tissues underwent immunostaining, and UCP1 content was quantified by Western blotting. Results: PET/CT showed low 18 F-FDG uptake in both BAT and inguinal WAT at baseline. BAT uptake was substantially increased by a single stimulation with CL316,243. Uptake in inguinal WAT was only modestly elevated by the first stimulation uptake but gradually increased to BAT level by prolonged stimulation. Ex vivo measurements recapitulated the PET findings, and measured 18 F-FDG uptake in other WAT depots was similar to inguinal WAT. WAT browning by prolonged stimulation was confirmed by a substantial increase in uncoupling protein 1 (UCP1), cytochrome-c oxidase 4 (COX4), and PR domain containing 16 (PRDM16) staining as markers of brown adipocytes. UCP1 content, which served as a measure for extent of browning, was low in baseline inguinal WAT but linearly increased over 10 d of CL316,243 injection. Finally, image-based and ex vivo-measured 18 F-FDG uptake in inguinal WAT correlated well with UCP1 content. Conclusion: 18 F-FDG PET/CT has the capacity to monitor brown adipocyte recruitment into WAT depots in vivo and may thus be useful for screening the efficacy of strategies to promote WAT browning. Subcut aneous and visceral white adipose tissue (WAT) contributes to obesity by storing excess energy as intracellular lipid (1,2). By contrast, brown adipose tissue (BAT) can have a negative influence on weight gain by dissipating energy as heat (3,4). This thermoregulatory response is mediated through norepinephrineactivated b3 adrenergic receptor (b3AR) signaling. The exciting recent revelation that functional BAT is present not only in animals and young children but also in human adults (5,6) has fueled attempts to exploit its energy-consuming property to counter obesity (7,8). Unfortunately, however, obese patients have insufficient amounts of BAT, limiting the value of constitutive BAT for weight reduction (9).On the other hand, obese subjects have abundant amounts WAT. It has recently become known that WAT can recruit clusters of adipocytes with a brownlike phenotype. This process, called WAT browning, can be seen in mice stimulated by prolonged cold exposure or by b3AR agonists as a mimetic of cold stress (10,11). Brownlike cells recruited by WAT browning are referred to as beige (pale brown) adipocytes (12)(13)...

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Section: Discussionmentioning

confidence: 69%

¹⁸F-FDG PET/CT Monitoring of β3 Agonist–Stimulated Brown Adipocyte Recruitment in White Adipose Tissue

et al. 2014

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“…Images revealed primary lung malignancy with co existing bilateral renal tuberculosis imitate metastases which otherwise would have gone amiss or would have been considered as metastases without dual phase [14]. In a case report the authors found useful delayed images in a case of benign retroperitoneal pheochromocytoma showing multiple hypermetabolic regions corresponding with common locations of Brown adipose tissue [15].…”

Section: Discussionmentioning

confidence: 98%

Is Dual-Time-Point Imaging Necessary for Discrimination of Adrenal Benign Lesions Versus Malignant Masses: A Study Comparing Standard Methods with Dual-Time-Point FDG PET-CT Imaging

Kara¹,

Koç²,

Kara³

et al. 2018

Chemotherapy

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Objectives: This retrospective study was designed to investigate the clinical role of FDG PET-CT, for the evaluation of adrenal lesions and to compare the standart methods with dual-time-point imaging (DTPI) method to distinguish benign from malignant lesions in various cancer patients. Materials and methods: A total of 60 patients with confirmed primary malignancies underwent PET-CT examinations. Of the 60 patients, 79 adrenal lesions (36 benign and 43 malignant adrenal lesions) were shown by CT. Patients were grouped as benign adrenal group (I), malignant adrenal group (II) and dual-phase-group (III). Results: A total of 20 (33%) patients were included in benign adrenal group (Group I) with 28 adrenal lesions. Mean SUVmax value 2.95 were evaluated. All adrenal lesions in Group I had SUVmax value below cutoff 4.2 except 2. A total of 19 (32%) patients were included in malignant adrenal group (Group II) with 22 adrenal lesions. Mean SUVmax value 8.16 were evaluated. All adrenal lesions in Group II had SUVmax value over cutoff 4.2 except 2. A total of 21 (35%) patients were included in dual phase adrenal group (Group III) with 29 adrenal lesions. For malignant adrenal lesions in group III, all of the 21 malign lesions showed increased FDG uptake and SUVmax value in late imaging. Conclusion: Dual time point imaging of PET-CT seems to be very effective especially in adrenal lesions, addition of dual phase study routinely is not necessary and recommented in only indeterminated lesions.

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“…The FDG uptakes of BAT commonly locate at the cervical, supraclavicular, paravertebral, mediastinal and perirenal region in adults, and the amount and extent of BAT decreases, even disappears with age from many areas including the omental and mesenteric regions [1]. However, previous case reports have observed the FDG uptake of mesenteric BAT in adult patients with catecholamine-secreting neoplasm such as pheochromocytoma or paraganglioma [2][3][4]. Their findings were based on the change of FDG uptake levels on dual-time point scans or after oral administration of β-adrenergic antagonist propranolol to patients.…”

Section: Conflict Of Interestmentioning

confidence: 99%

“…Examples of relatively atypical locations for BAT include posterior neck, paratracheal and perirenal area [1]. Reports of the activation of BAT in the mesentery are rare and have lacked direct histological evidences [2][3][4].…”

Section: Unusual Fdg Uptakes Of Mesenteric Brown Adipose Tissue In a mentioning

confidence: 99%

Unusual FDG uptakes of mesenteric brown adipose tissue in a patient with pheochromocytomas

Li¹,

Zhang²,

Jin³

2016

Nuklearmedizin

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Hypermetabolic Mesenteric Brown Adipose Tissue on Dual-Time Point FDG PET/CT in a Patient With Benign Retroperitoneal Pheochromocytoma

Cited by 20 publications

References 9 publications

¹⁸F-FDG PET/CT Monitoring of β3 Agonist–Stimulated Brown Adipocyte Recruitment in White Adipose Tissue

¹⁸F-FDG PET/CT Monitoring of β3 Agonist–Stimulated Brown Adipocyte Recruitment in White Adipose Tissue

Is Dual-Time-Point Imaging Necessary for Discrimination of Adrenal Benign Lesions Versus Malignant Masses: A Study Comparing Standard Methods with Dual-Time-Point FDG PET-CT Imaging

Unusual FDG uptakes of mesenteric brown adipose tissue in a patient with pheochromocytomas

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Hypermetabolic Mesenteric Brown Adipose Tissue on Dual-Time Point FDG PET/CT in a Patient With Benign Retroperitoneal Pheochromocytoma

Cited by 20 publications

References 9 publications

18F-FDG PET/CT Monitoring of β3 Agonist–Stimulated Brown Adipocyte Recruitment in White Adipose Tissue

18F-FDG PET/CT Monitoring of β3 Agonist–Stimulated Brown Adipocyte Recruitment in White Adipose Tissue

Is Dual-Time-Point Imaging Necessary for Discrimination of Adrenal Benign Lesions Versus Malignant Masses: A Study Comparing Standard Methods with Dual-Time-Point FDG PET-CT Imaging

Unusual FDG uptakes of mesenteric brown adipose tissue in a patient with pheochromocytomas

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¹⁸F-FDG PET/CT Monitoring of β3 Agonist–Stimulated Brown Adipocyte Recruitment in White Adipose Tissue

¹⁸F-FDG PET/CT Monitoring of β3 Agonist–Stimulated Brown Adipocyte Recruitment in White Adipose Tissue