Patients with pheochromocytomas and paragangliomas (PGLs) may have brown adipose tissue (BAT) activation induced by catecholamine excess. (18)F-fluorodeoxyglucose ((18)F-FDG) PET/CT can be used for the localization of both PGLs and BAT. It is unknown whether BAT is specifically affected by altered cellular energy metabolism in patients with SDHx and VHL-related PGLs.To determine endocrine and paracrine effects of catecholamine excess on BAT activation in patients with PGLS as detected by (18)F-FDG PET/CT, taking into account genetic variation.Patients with PGLs who were fully genetically characterized underwent pre-surgical (18)F-FDG PET/CT imaging for tumor localization and to quantify BAT activation.Single Dutch tertiary referral centre.73 patients, age 52.4 ± 15.4 yr, BMI 25.2 ± 4.1 kg/m(2), mean ± SD, were grouped into sporadic, cluster 1 (SDHx, VHL) and cluster 2 (RET, NF1, MAX) mutations.(18)F-FDG mean standard uptake values (SUVmean) were assessed in predefined BAT locations, including perirenal fat.21/73 (28.8\%) patients exhibited BAT activation. BAT activation was absent in all six patients with non-secreting PGLs. No difference in (18)F-FDG uptake by perirenal fat on the side of the pheochromocytoma and the contralateral side was observed (SUVmean 0.80 vs. 0.78 respectively, P=0.42). The prevalence of BAT activation did not differ between sporadic (28.9\%), cluster 1 (40.0\%) and cluster 2 patients (15.4\%), P=0.36.Patients with PGLs exhibit a high prevalence of BAT activation on (18)F-FDG PET/CT. This is likely due to systemic catecholamine excess. BAT activation is not associated with specific germline mutations.
Related url:
http://dx.doi.org/10.1210/jc.2015-3205