Effect of Propranolol on 18F-Fluorodeoxyglucose Uptake in Brown Adipose Tissue in Children and Young Adults with Neoplastic Diseases

Brady, Samuel L.; Wong, Ka Kit; Doubrovin, Mikhail; Han, Yuanyuan; Li, Yimei; Wu, Shengjie; Hossain, A; Chism, Charles B.; Naik, Mihir; Rossi, Michael; Shulkin, Barry L.

doi:10.1007/s11307-020-01547-z

Cited by 10 publications

(15 citation statements)

References 30 publications

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“…Since then its uptake was reported by several other radiopharmaceuticals including sestamibi and was attributed to higher mitochondrial activity in the brown fat tissue [9]. Previous studies revealed brown adipose tissue to be more common in children and young adults compared to older individuals [10]. In our study of pediatric and adult patients with sHPT, brown fat sestamibi uptake was observed in 22% of pediatric patients with sHPT.…”

Section: Discussionsupporting

confidence: 59%

Comparison of parathyroid scintigraphy findings in pediatric and adult patients with secondary hyperparathyroidism

Aktaş¹,

Baskın²,

Gençoğlu³

et al. 2023

Nuclear Medicine Communications

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Objectives Secondary hyperparathyroidism (sHPT) is a compensatory complication of chronic kidney disease. The aim of this study was to compare PS findings in pediatric and adult patients with sHPT. Methods This study included 50 pediatric and 50 adult patients with sHPT. Parathyroid scintigraphy was performed with Tc-99m sestamibi. After radiopharmaceutical injection, early-phase (15 min) and late-phase (60–90 min) images were acquired. Planar images were interpreted visually for the presence / number of active foci compatible with a parathyroid lesion, the presence and degree of uptake in skeletal structures, and the degree of thyroid sestamibi uptake. Parathyroid surgery was performed in 21 pediatric and 28 adult patients. Results Serum PTH and ALP values were significantly higher in pediatric than in adult patients (P < 0.05 for each). In operated patients, on a lesion-based analysis, the sensitivity of PS in pediatric and adult patients were 40% and 71%, respectively. A nonlocalizing scan was observed in 24% of pediatric patients. Pediatric patients had a higher incidence of reduced thyroid sestamibi uptake (42% versus 2%). Skeletal sestamibi uptake was detected in 40% of pediatric and 30% of adult patients and the degree of uptake was higher in pediatric patients. Conclusions The results revealed more significant changes in the biochemical profile of pediatric compared with adult patients with sHPT. The sensitivity of PS was lower, and the likelihood of a nonlocalizing scan was higher in pediatric patients. The results may also suggest more severe skeletal findings in pediatric patients. Reduced thyroid sestamibi uptake in children needs further evaluation.

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Section: Discussionsupporting

confidence: 59%

Comparison of parathyroid scintigraphy findings in pediatric and adult patients with secondary hyperparathyroidism

Aktaş¹,

Baskın²,

Gençoğlu³

et al. 2023

Nuclear Medicine Communications

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“…However, in an animal model propranolol at a dosage of 5 mg/kg body weight was able to abrogate the effect of a selective β 3 -AR-agonist on glucose uptake into BAT as determined by 18 F-FDG-PET/CT ( 33 ). Moreover, interventional studies in euthyroid patients undergoing routine 18 F-FDG-PET/CT scans showed that prior administration of propranolol minimizes FDG uptake into BAT as compared to control ( 15 – 17 ). Most of these studies were performed with a single dose of 20 to 80 mg propranolol.…”

Section: Discussionmentioning

confidence: 99%

“…However, the acute effects of β-blockers on REE in patients with hyperthyroidism are currently unclear. Several interventional studies demonstrated a reduction of cold-induced BAT activity in 18 F-FDG-PET/CT scans after blocking the β-ARs with propranolol in euthyroid patients ( 15 – 17 ).…”

Section: Introductionmentioning

confidence: 99%

Acute effect of propranolol on resting energy expenditure in hyperthyroid patients

Senn

Löliger²,

Fischer³

et al. 2023

Front. Endocrinol.

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ObjectiveHyperthyroidism is a common endocrine disorder which leads to higher resting energy expenditure (REE). Increased activity of brown adipose tissue (BAT) contributes to elevated REE in hyperthyroid patients. For rapid control of hyperthyroid symptoms, the non-selective β-blocker propranolol is widely used. While, long-term treatment with propranolol reduces REE it is currently unclear whether it can also acutely diminish REE.DesignIn the present prospective interventional trial we investigated the effect of propranolol on REE in hyperthyroid patients.MethodsNineteen patients with overt primary hyperthyroidism were recruited from the endocrine outpatient clinic. REE was measured by indirect calorimetry before and after an acute dose of 80mg propranolol and during a control period, respectively. Additionally, skin temperature was recorded at eleven predefined locations during each study visit, vital signes and heart rate (HR) were measured before and after administration of propranolol.ResultsMean REE decreased slightly after acute administration of 80mg propranolol (p= 0.03) from 1639 ± 307 kcal/24h to 1594 ± 283 kcal/24h. During the control visit REE did not change significantly. HR correlated significantly with the level of free T3 (R2 = 0.38, p=0.029) free T4 (R2 = 0.39, p=0.026). HR decreased 81 ± 12 bpm to 67 ± 7.6 bpm 90 minutes after oral administration of propranolol (p<0.0001). Skin temperature did not change after propranolol intake.ConclusionsIn hyperthyroid patients a single dose of propranolol reduced heart rate substantially but REE diminished only marginally probably due to reduced myocardial energy consumption. Our data speak against a relevant contribution of BAT to the higher REE in hyperthyroidism.Clinical trial registrationClinicalTrials.gov, identifier (NCT03379181).

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“…This was lower than expected based on existing prior studies in pediatric patients, which reported incidences of 35% to 47%. 6,7,12 However, some adult studies, including those with wide age ranges, including children and adults, have BAT incidences as low as 1.9%. 1,13,14 Children have an estimated 10-fold higher incidence of BAT than adults; thus, we estimated a 40% to 50% BAT incidence.…”

Section: Discussionmentioning

confidence: 99%

“…2 Numerous studies have shown a decrease or absence of BAT when propranolol is administered before PET imaging. [3][4][5][6][7] Therefore, pre-PET treatment with medications such as propranolol, diazepam, and fentanyl is sometimes used. However, not all patients' PET scans are complicated by BAT; therefore, identifying patients at most risk and who would most benefit from prophylaxis is important.…”

mentioning

confidence: 99%

Incidence and Risk Factors for Brown Adipose Tissue Uptake in PET Imaging in Pediatric Patients

Smolik,

Miller,

Mong

et al. 2023

Journal of Pediatric Hematology/Oncology

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Background: Positron emission tomography (PET) scans are used in disease diagnosis and evaluation for pediatric oncology patients. Brown adipose tissue (BAT) 18F-fluorodeoxyglucose-PET uptake is reported in 35% to 47% of pediatric patients. Several risk factors may be associated with BAT uptake. Objective: The aim was to determine the incidence and risk factors for BAT in pediatric patients using a consensus-based system and a novel grading scale. Methods: A total of 285 PET scans in 154 patients were retrospectively reviewed for the presence of BAT from September 2015 through December 2016. A consensus review was done by 2 radiologists, who graded BAT on a 0 to 3 scale and assessed its impact on PET interpretation. Results: The presence of moderate to severe BAT occurred in 11% of PET scans, and 6% of PETs had limited interpretation. Hodgkin lymphoma (n=53) patients had a 3.62-fold increased odds of moderate or severe BAT and a 6.59-fold increased odds of limited interpretation on PET imaging. Conclusion: The incidence of BAT was low but impacted radiologic interpretation when present. Further studies with a larger group of Hodgkin lymphoma patients are needed to explore the risk factors associated with moderate or severe BAT.

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Effect of Propranolol on 18F-Fluorodeoxyglucose Uptake in Brown Adipose Tissue in Children and Young Adults with Neoplastic Diseases

Cited by 10 publications

References 30 publications

Comparison of parathyroid scintigraphy findings in pediatric and adult patients with secondary hyperparathyroidism

Comparison of parathyroid scintigraphy findings in pediatric and adult patients with secondary hyperparathyroidism

Acute effect of propranolol on resting energy expenditure in hyperthyroid patients

Incidence and Risk Factors for Brown Adipose Tissue Uptake in PET Imaging in Pediatric Patients

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