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Updated: Dec 5, 2025
Functional Imaging of Brown Fat in Mice with 18F-FDG micro-PET/CT
Published on: November 23, 2012
Effect of Propranolol on 18F-Fluorodeoxyglucose Uptake in Brown Adipose Tissue in Children and Young Adults with
Samuel L Brady1, Ka Kit Wong2, Mikhail Doubrovin3
1Department of Radiology, Cincinnati Children's Hospital Medical Center & University of Cincinnati, Cincinnati, OH, USA.
Purpose:
To evaluate the effectiveness of propranolol at mitigating FDG uptake in brown adipose tissue (BAT) of pediatric patients with known or suspected malignancies.
Methods:
PET/CT scans of 3 cohorts of patients treated from 2005 to 2017 were scored for the presence of FDG uptake by BAT at 7 sites: right or left neck/supraclavicular area, right or left axilla, mediastinum, posterior thorax, and abdomen/pelvis. Uptake was scored as follows: 0, none; 1, mild uptake < liver; 2, moderate uptake = liver; and 3, intense uptake > liver. Group 1 consisted of 323 patients (630 scans) who had no specific preparation to mitigate FDG uptake by BAT. Group 2 consisted of 345 patients (705 scans) who underwent only warming in an uptake room with a fixed temperature at 24 °C. Group 3 consisted of 622 patients (1457 scans) who underwent warming. In group 3, patients 8 years and older, 471 patients (1114 scans), were also pre-medicated with oral propranolol 60 min before injection of FDG. Generalized estimation equation, using the logit link method, was used to model the relationship between the incidence of BAT score > 0, in any site, as a function of age, sex, seasonal effect, and body surface area (BSA).
Results:
In patients aged 8 years or older, the incidence of BAT uptake was 35-44 % and declined to 15 % with propranolol. BAT was most frequent in the neck (26 %), axilla (18 %), posterior thorax (18 %), mediastinum (14 %), and abdomen/pelvis (8 %); BAT was less common in warm months (p = 0.001). No substantial benefit was shown with pre-injection warming alone. No significant effect was found for age, sex, or BSA separately. When BAT uptake was present, it was usually intense.
Conclusion:
Propranolol preparation minimizes FDG uptake by BAT and should be considered routine for pediatric FDG PET/CT cancer-related protocols in children, adolescents, and young adults.
Insights
Propranolol effectively reduces fluorodeoxyglucose (FDG) uptake in brown adipose tissue (BAT) for pediatric cancer imaging. This preparation should be standard for FDG PET/CT scans in children and young adults.
Area of Science:
- Nuclear Medicine
- Radiopharmacology
- Pediatric Oncology
Background:
- Brown adipose tissue (BAT) exhibits fluorodeoxyglucose (FDG) uptake, which can interfere with PET/CT imaging in pediatric patients.
- Mitigating FDG uptake in BAT is crucial for accurate cancer detection and staging in children.
Purpose of the Study:
- To assess the efficacy of propranolol in reducing FDG uptake in the brown adipose tissue of pediatric patients undergoing PET/CT scans.
- To determine if propranolol administration is a viable strategy for improving the diagnostic quality of cancer-related PET/CT protocols in pediatric oncology.
Main Methods:
- Retrospective analysis of 3 cohorts (2005-2017) of pediatric patients undergoing PET/CT scans.
- Scoring of FDG uptake in BAT across seven anatomical sites.
- Comparison of uptake levels between patients with no preparation, warming alone, and warming with propranolol pre-medication (for patients aged 8+).
Main Results:
- Propranolol significantly decreased BAT FDG uptake from 35-44% to 15% in patients aged 8 years and older.
- Warming alone showed no substantial benefit in reducing FDG uptake.
- BAT uptake was most prevalent in the neck, axilla, and posterior thorax, and less common during warmer months.
Conclusions:
- Propranolol administration effectively minimizes FDG uptake in brown adipose tissue for pediatric PET/CT scans.
- Routine use of propranolol should be considered for pediatric FDG PET/CT cancer-related protocols.
- This strategy can enhance the accuracy of oncologic imaging in children, adolescents, and young adults.
![Visualization and Quantification of Brown and Beige Adipose Tissues in Mice using [18F]FDG Micro-PET/MR Imaging](/_next/image?url=https%3A%2F%2Fcloudfront.jove.com%2FCDNSource%2Fteasers%2F62460.jpg&w=3840&q=50)
