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Clinical Trial
. 2023 Dec 11;13(1):21944.
doi: 10.1038/s41598-023-48871-2.

Prevention of activated brown adipose tissue on 18F-FDG-PET scans of young lymphoma patients: results of an ancillary study within the EuroNet-PHL-C2 trial

C Pötzsch #  1 , Lars Kurch #  2 , S Naumann  1 , T W Georgi  1 , O Sabri  1 , D Stoevesandt  3 , M Cepelova  4 , D Körholz  5 , C Mauz-Körholz  5 , D Hasenclever #  6 , R Kluge #  1
Affiliations
Clinical Trial

Prevention of activated brown adipose tissue on 18F-FDG-PET scans of young lymphoma patients: results of an ancillary study within the EuroNet-PHL-C2 trial

C Pötzsch et al. Sci Rep. .

Abstract

Activated brown fat (aBAT) is known to affect the evaluation of 18F-FDG PET scans, especially in young patients. The aim of this study was to determine factors influencing the occurrence of aBAT, and to investigate the effectiveness of the two preventive measures, warming and beta-blocker (propranolol) administration. Five-hundred-twenty-eight 18F-FDG-PET scans of 241 EuroNet-PHL-C2 trial patients from 41 nuclear medicine departments in Germany and Czech Republic were screened for aBAT. The occurrence of aBAT was analyzed with patient characteristics (age, sex, body mass index, predisposition to aBAT), weather data at the day of 18F-FDG PET scanning as well as the preventive measures taken. Potentially important factors from univariate analyses were included into a logistic regression model. Warming as a preventive measure was used in 243 18F-FDG-PET scans, propranolol was administered in 36, warming and propranolol were combined in 84, and no preventive measures were taken in 165 scans. Whereas age, sex and body mass index had no clear impact, there was an individual predisposition to aBAT. Logistic regression model revealed that the frequency of aBAT mainly depends on the outside temperature (p = 0.005) and can be effectively reduced by warming (p = 0.004), the administration of unselective beta-blocker or the combination of both. Warming is a simple, cheap and non-invasive method to reduce the frequency of aBAT. However, the effect of warming decreases with increasing outside temperatures. Administration of propranolol seems to be equally effective and provides advantages whenever the positive effect of warming is compromised. The combination of both preventive measures could have an additive effect.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Influence of BMI_sds on the frequency of aBAT (blue curve). Green circles = no aBAT, red circles = aBAT. Dashed line = basis rate of aBAT.
Figure 2
Figure 2
Influence of the average outdoor temperature on the frequency of aBAT (blue curve). Green circles = no aBAT, red circles = aBAT. Dashed line = basis rate of aBAT.
Figure 3
Figure 3
Interrelation between the outside temperature and the execution of preventive measures: (a) warming the patient (blue line = proportion of patients warmed), (b) administration of propranolol (blue line = proportion of patients in whom propranolol was given). Green circles = no aBAT, red circles = aBAT.
Figure 4
Figure 4
Probability of aBAT as a function of the average outdoor temperature and use of preventive measures.
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