Abstract
781
Objectives: Brown adipose tissue, also known as brown fat, has been known to interfere with PET/CT imaging due to its rapid uptake of FDG. This is mostly detected in the subclavian area during colder temperatures when brown fat is activated to warm the area. In the past, thermal imaging has been used to detect the activated brown fat. This work is to explore whether activated brown fat found using thermal imaging can be decreased prior to imaging by intervening with additional warming of the patient in activated areas.
Methods: Patients with low BMI were consented to have thermal imaging of their torso at two time points: one prior to injection and the other prior to their standard imaging procedure. The typical patient workflow first included the acquisition of a thermal image prior to FDG injection followed by thermal imaging after a 60 min uptake, and finally their standard PET. Patients were split into control and research groups. For research patients, if activated brown fat was detected using thermal imaging, patients were given warmed blankets to heat their subclavian area for 10 min prior to injection and a new warm blanket every 15 min during uptake. Control patients differed from research patients in that no warming intervention was used if activated brown fat was observed using thermal imaging.
Results: Thermal images showed activated brown fat in selected patients. Increases in brown fat during the 60 min uptake time were observed in control patient with PET imaging positive for brown fat activation. Patients where additional warming interventions were used showed reduced or eliminated brown fat in sequential thermal imaging and PET images were negative for brown fat uptake.
Conclusion: Thermal imaging during routine PET/CT for patients with low BMI may enable staff to intervene in a manner that may help reduce the uptake of brown fat which can lead to decreased diagnostic confidence.