Brown fat activation demonstrated on FDG PET/CT predicts survival outcome

• Published in: Journal of cancer research and clinical oncology Vol. 149; no. 8; pp. 4847 - 4851
• Main Authors: Park, Sonya Youngju, Choi, Eun Kyoung, Oh, Jin Kyoung, Oh, Joo Hyun, Yoo, Ie Ryung, Chung, Yong An
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.07.2023; Springer Nature B.V
• Subjects: Bats; Breast cancer; Cancer Research; Hematology; Internal Medicine; Medical prognosis; Medicine; Medicine & Public Health; Menopause; Oncology; Positron emission tomography; Post-menopause; Survival; Tumor microenvironment; Brown adipose tissue; Brown fat; Breast cancer; Prognosis; FDG PET/CT
• ISSN: 0171-5216; 1432-1335
• DOI: 10.1007/s00432-022-04390-7

Purpose The purpose of this study was to compare the survival of patients with and without BAT activity on FDG PET/CT. Methods PET/CT exams from 3937 breast cancer patients were retrospectively reviewed for bilateral symmetric elongated FDG activity in the neck and chest, typical of BAT activation. A control group of age-matched (± 1 year) breast cancer patients who underwent PET/CT the same week was also enrolled for comparison. Kaplan–Meier curves of progression-free survival (PFS) and overall survival (OS) for BAT positive patients and the control group were calculated. Further sub-analysis was performed to account for the hormonal changes associated with menopause. Results 2.0% (80/3937) of the breast cancer patients who underwent PET/CT demonstrated BAT activation, and 80 additional patients were analyzed for comparison as the group without BAT activity. Mean follow-up was 76 months (range 1–225 months). There were 4 recurrences in the BAT group, compared to 12 in the control. The mean PFS for the BAT group was 127 months, which was significantly lower than the mean PFS of 180 months in the control ( p  = 0.047). Sub-analysis of premenopausal women again showed longer PFS for the BAT group (129 vs. 196 months, p  = 0.095) while no difference was found in postmenopausal women (mean 102 vs. 135 months, p  = 0.360). Presence of BAT activity was also a significant predictor variable for PFS on Cox regression. Conclusion Patients with BAT activity showed longer progression-free survival than those without, emphasizing the need for further evaluation of its role in metabolism, treatment response, tumor microenvironment and long-term prognosis.