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Published online by Cambridge University Press: 07 October 2011
Imaging description
Brown adipose tissue is extremely important in regulating energy expenditure and maintaining normal body temperature in newborn infants. The absolute amount and percentage of brown fat versus white fat decreases with age. In the past, brown fat was not thought to play a role in adult temperature control. PET/CT scanning demonstrates the presence of brown fat activation in adults by intense FDG uptake (Figure 77.1). Colder temperatures and anxiety enhance FDG uptake. On PET/CT, FDG uptake in brown fat is predominantly located in the neck, supraclavicular and paravertebral areas, and is inversely related to body mass index (BMI) and percent body fat. Children and adolescents may have FDG uptake in brown fat in the upper abdomen and adjacent to the diaphragm [1–3].
Importance
The intense irregular FDG accumulation produced by brown fat activation can mimic nodal disease, potentially leading to unnecessary workup and treatment if misinterpreted. Alternatively, brown fat activation can obscure small or subtle foci of recurrent disease.
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