We aimed to shed some light on the relation between brown adipose tissue
(BAT) visualisation on FDG PET/CT at diagnosis in children with Hodgkin lymphoma
(HL) and the main determinants reported in adult HL, outside temperature, gender, age,
but also with the metabolic activity of HL lesions and of some organs that did not look
to be invaded by HL.
Pre therapeutic FDG PET/CT was performed in 135 children or adolescents suffering
from HL and was centrally blind read, in search for BAT visualisation, determination
of SUVmax of the liver, the bone marrow at the iliac crest and the spinal cord at Th12,
providing those sites did not show focal uptake evocative of HL. The maximum
SUVmax, total metabolic tumour volume, and total lesion glycolysis of HL were also
The visualisation of BAT as foci of FDG uptake in those patients with paediatric HL
was not significantly associated with gender, age, the outside temperature on the day of
PET/CT, the intensity of FDG in non-invaded organs and maximum SUVmax of HL
tumours. There was a trend for an association with lower tumour volume and lower
total lesion glycolysis of HL that did not reach the statistical significance level.
Our study confirms, in 135 paediatric HL patients at diagnosis, i.e. a homogeneous
clinical status, previous evidence derived from heterogeneous conditions, that the
epidemiology of BAT activation is quite different between paediatric patients and
adults. In relation to HL, BAT activation was not linked with the metabolic activation
of the liver, the bone marrow, and the spinal cord, which may be observed as a consequence of HL presence in the patient. Nevertheless, our results suggest that BAT
visualisation could be associated with a lower HL tumour mass.
Keywords: Bone Marrow, Brown Adipose Tissue (BAT), Child, FDG PET/CT, Liver, Lymphoma, Outside Temperature, Paediatric Hodkgin’s Lymphoma, Spinal Cord, SUVmax, Total Lesion Glycolysis (TLG), Total Metabolic Tumour Volume (TMTV).