Correlation of cancer status and brown adipose tissue activity on 18F-flourodeoxyglucose positron emission tomography/computed tomography

Abstract

Aim: In this study, we aimed to compare brown adipose tissue (BAT) activity on 18F-Flourodeoxyglucose Positron Emission Tomography (PET)/Computed Tomography(CT) in patients with and without active cancer. Material and Methods: Results of the patients who underwent 18F-FDG PET/CT between January 2014 and February 2018 in Nuclear Medicine Department were evaluated retrospectively. Age, gender, body mass index (BMI), serum levels of glucose, bilirubin, total cholesterol (T-chol), low-density lipoprotein (LDL) and triglyceride (TG) of the patients were noted from the hospital database. Mean outdoor temperature of the day during PET/CT imaging was searched from National Weather Service archives. Diagnosis and disease activity status on PET/CT imaging were evaluated retrospectively. Standardized uptake value (SUV) and brown adipose tissue volume (BAV) were calculated on PET/CT images. Additionally, hepatic attenuation index and subcutaneous adipose tissue thickness (SCATT) were calculated from CT images. Difference between median SUV and BAV among groups with and without active cancer was analyzed. Results: Totally 78 (54 F; 24 M; mean age 34.415.6) patients who underwent 18F-FDG PET/CT for different oncological indications were included in the analysis. All the patients had different degrees of BAT uptake on PET/CT images. Median (min-max) values for SUV, BAV and SCATT were found as 8.0 (2.7-37.0), 26.9 (2.1- 116.0) cm3 and 15.0 (3.0- 46.0) mm, respectively. Hepatic attenuation index was 0-5%, 6-30% and >30% in 56 (71%), 20 (26%) and 2 (3%) patients, respectively. Active disease was observed in 26 (33%) patients during PET/CT imaging. In the evaluation of the distribution of the adipose tissue parameters, median SUV (p=0.008) and BAV (p=0.008) of groups with and without active cancer were found statistically significant. Conclusion: BAT activity in patients with active cancer seems to be higher than that in patients without active disease, supporting the possible role of adipose tissue activation on cancer development and progression.

Keywords

• Brown adipose tissue
• positron emission tomography
• Fluorodeoxyglucose F18

18F-Fluorodeoksiglukoz positron emisyon tomografi/bilgisayarlı tomografi’de kahverengi yağ dokusu aktivitesi ve kanser durumunun korelasyonu

Abstract

Amaç: Bu çalışmada 18F-Fluorodeksiglukoz (FDG) positron emisyon tomografi/ bilgisayarlı tomografi (BT)’de aktif kanseri olan ve olmayan hastalarda kahverengi yağ dokusu (KYD) aktivitesinin kıyaslanmasını amaçladık. Gereç ve Yöntemler: Ocak 2014-Şubat 2018 tarihleri arasında kliniğimizde tüm vücut 18F-FDG PET/BT çekilen hastaların raporları hastane kayıtlarından araştırıldı. Yaş, cinsiyet, vücut kitle indeksi (VKİ), kan glukoz, bilirubin, total kolesterol (T-kol), düşük dansiteli lipoprotein (LDL) ve trigliserit (TG) düzeyleri not edildi. PET/BT görüntülemesi sırasında ortalama dış mekan hava sıcaklığı internetten araştırıldı. Tanı ve PET/BT sırasında hastalık aktivitesi hastane kayıtlarından araştrıldı. Standardize uptake değeri (SUV) ve kahverengi yağ dokusu volümü (KYV) PET/BT görüntülerinden hesaplandı. Ek olarak hepatic atenüasyon indeksi ve subkutan yağ dokusu kalınlığı (SKYDK) BT görüntülerinden hesaplandı. Aktif kanseri olan ve olmayan gruplar arasında median SUV ve KYV farkları analiz edildi. Bulgular: Çeşitli onkolojik endikasyonlarla 18F-FDG PET/BT çekilen toplam 78 hasta (54 K; 24 E; ortalama yaş 34.415.6) çalışmaya dahil edildi. Her hastanın PET/BT görüntülerinde farklı KYD tutulumu vardı. SUV, KYV ve SKYDK için median değerleri sırasıyla 8.0 (2.7-37.0), 26.9 (2.1- 116) cm3 and 15.0 (3.0- 46.0) mm olarak bulundu. Hepatosteatoz indeksi 56 hastada (%71) %0-5, 20 hastada (26%) %6-30 ve 2 hastada (3%) >%30 idi. 26 hastada (33%) PET/BT görüntüleme sırasında aktif hastalık mevcuttu. Kahverengi yağ dokusu parametrelerinin gruplar arasında dağılımının incelemesinde, aktif kanseri olan ve olmayan hastalarda median SUV (p=0.008) ve KYV (p=0.008) değerleri arasında anlamlı farklılık bulundu. Sonuç: Kanser gelişimi ve progresyonununda kahverengi yağ dokusu aktivasyonunun muhtemel rolünü destekler nitelikte olmak üzere, aktif kanseri olan hastalarda, olmayanlara göre KYD aktivitesi daha yüksek görünmektedir.

Keywords

• kahverengi yağ dokusu
• poziton emisyon tomografi
• fluorodeoksiglukoz F-18

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