TY - JOUR T1 - Brown Fat Imaging with <sup>18</sup>F-6-Fluorodopamine PET/CT, <sup>18</sup>F-FDG PET/CT, and <sup>123</sup>I-MIBG SPECT: A Study of Patients Being Evaluated for Pheochromocytoma JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 1077 LP - 1083 DO - 10.2967/jnumed.106.035915 VL - 48 IS - 7 AU - Mohiuddin Hadi AU - Clara C. Chen AU - Millie Whatley AU - Karel Pacak AU - Jorge A. Carrasquillo Y1 - 2007/07/01 UR - http://jnm.snmjournals.org/content/48/7/1077.abstract N2 - Several radiopharmaceuticals such as 18F-FDG, 123I-metaiodobenzylguanidine (MIBG), and 99mTc-tetrofosmin have demonstrated uptake in brown adipose tissue (BAT). It is important to recognize these normal variants so that they are not misinterpreted as a significant pathologic state. In addition, these radiopharmaceuticals may shed light on BAT physiology. 18F-6-fluorodopamine (F-DA) is being used as a PET radiopharmaceutical to image adrenergic innervation and suspected pheochromocytoma. Past reports have suggested that BAT is increased in pheochromocytoma patients. Methods: The images of 96 patients evaluated with 18F-F-DA or 18F-FDG PET/CT for known or suspected pheochromocytoma were reviewed retrospectively to determine whether localized uptake of a pattern typically associated with BAT was present. When available, contemporaneous images obtained using 123I-MIBG were also reviewed for the presence of BAT. Results: Of 67 patients imaged with 18F-F-DA, BAT was found in 17.9%. Of 83 patients imaged with 18F-FDG, 19.2% had BAT. Discordant findings related to uptake in BAT were often seen in patients studied with 18F-FDG, 18F-F-DA, or 123I-MIBG. Overall, 26 (27.0%) of 96 patients showed BAT on at least 1 of the 3 imaging modalities. Conclusion: 18F-F-DA can image BAT, most likely by localizing to sympathetic innervations in a manner similar to 123I-MIBG. Patients with pheochromocytoma may have a greater BAT tissue mass or activation because of elevated levels of circulating catecholamines. Quantitative PET with 18F-FDG and 18F-F-DA may have a role in in vivo studies of BAT physiology in humans or animal models. ER -