Altered biodistribution on FDG-PET with emphasis on brown fat and insulin effect
Abstract
(18)F-fluorodeoxyglucose (FDG) is the radiotracer used in the vast majority of positron emission tomography (PET) cancer studies. FDG is a powerful radiotracer that provides valuable data in many cancer types. Normal FDG biodistribution is easily identified. In the PET-only era, physiological uptake provided important anatomical landmarks. However, the normal biodistribution of FDG is often variable and can be altered by intrinsic or iatrogenic factors. Recognizing these patterns of altered biodistribution is important for optimal FDG-PET interpretation. Altered FDG uptake in muscles, brown adipose tissue, bone marrow, the urinary tract, and the bowel is demonstrated in a significant proportion of patients, which can hide underlying malignant foci or mimic malignant lesions. The introduction of PET/computed tomography revolutionized PET imaging, bringing much-needed anatomical information. This modality allowed better characterization of some types of uptake, particularly brown adipose tissue FDG uptake. Different approaches to minimize interference from altered FDG biodistribution should be considered when performing PET scans. Otherwise, careful review and correlation of metabolic (FDG-PET) and anatomical (computed tomography) data should be performed to accurately characterize the foci of increased FDG uptake.
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Many noncancerous tissues, including the brain, are FDG-PET avid, showing that high glucose uptake is not unique to tumors.
“Notably, many noncancerous tissues, including the brain, are FDG-PET avid (Berti et al., 2014; Cohade, 2010), illustrating that high glucose uptake is not a unique feature of tumors and offering a potential explanation for the relative lack of success in directly targeting glucose metabolism for cancer treatment.”
From Targeting Metabolism for Cancer Therapy (2017) · cites this paper as Cohade, 2010
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- Authors
- Cohade, C.
- Affiliations
- Centre Hospitalier de l’Université de Montréal (CA)
- Corresponding author
- Cohade, Christian
- Venue
- Seminars in Nuclear Medicine
- Publisher
- Elsevier BV
- Published
- 2010-07
- Volume
- 40
- Issue
- 4
- Pages
- 283-293
- ISSN
- 0001-2998 (ISSN-L)
- OpenAlex
- W2001847653
- Cited by
- 47
- References
- 71
- Citations by year
- 2026: 2 · 2024: 2 · 2022: 1 · 2021: 3 · 2020: 3 · 2019: 3 · 2018: 1 · 2017: 4 · 2016: 1 · 2015: 4 · 2014: 5 · 2013: 6 · 2012: 3
- FWCI
- 0.78
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Seminars in Nuclear Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiopharmaceutical Chemistry and Applications
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
- Keywords
- 18F-fluorodeoxyglucose, brown adipose tissue, physiological FDG uptake, PET/CT, tumor imaging, bone marrow uptake, muscle uptake
- MeSH terms
- Adipose Tissue, Brown, Humans, Insulin, Tissue Distribution, Artifacts, Radiopharmaceuticals, Fluorodeoxyglucose F18, Positron-Emission Tomography
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