Brown Adipose Tissue: Multimodality Evaluation by PET, MRI, Infrared Thermography, and Whole-Body Calorimetry (TACTICAL-II)

Lijuan Sun, Sanjay Verma, Navin Michael, Siew Pang Chan, Jianhua Yan, Suresh Anand Sadananthan, Stefan G Camps, Hui Jen Goh, Priya Govindharajulu, John Totman, David Townsend, Julian Pak-Nam Goh, Lei Sun, Bernhard Otto Boehm, Su Chi Lim, Siew Kwan Sze, Christiani Jeyakumar Henry, Houchun Harry Hu, S Sendhil Velan, Melvin Khee-Shing Leow, Lijuan Sun, Sanjay Verma, Navin Michael, Siew Pang Chan, Jianhua Yan, Suresh Anand Sadananthan, Stefan G Camps, Hui Jen Goh, Priya Govindharajulu, John Totman, David Townsend, Julian Pak-Nam Goh, Lei Sun, Bernhard Otto Boehm, Su Chi Lim, Siew Kwan Sze, Christiani Jeyakumar Henry, Houchun Harry Hu, S Sendhil Velan, Melvin Khee-Shing Leow

Abstract

Objective: This study aimed to compare the associations of positron emission tomography (PET), magnetic resonance (MR), and infrared thermography (IRT) imaging modalities with energy expenditure (EE) after brown adipose tissue (BAT) activation using capsinoid ingestion and cold exposure.

Methods: Twenty participants underwent PET-MR, IRT imaging, and whole-body calorimetry after capsinoid ingestion and cold exposure. Standardized uptake values (SUV) and the fat fraction (FF) of the supraclavicular brown adipose tissue regions were estimated. The anterior supraclavicular temperature (Tscv) from IRT at baseline and postintervention was measured. Two-hour post-capsinoid ingestion EE and post-cold exposure EE served as a reference to correlate fluorodeoxyglucose uptake, FF, and Tscv for BAT assessment. IRT images were geometrically transformed to overlay on PET-MR for visualization of the hottest regions.

Results: The supraclavicular hot spot identified on IRT closely corresponded to the area of maximal fluorodeoxyglucose uptake on PET images. Controlling for body weight, post-cold exposure Tscv was a significant variable associated with EE (P = 0.025). The SUV was significantly inversely correlated with FF (P = 0.012) and significantly correlated with peak of Tscv during cold exposure in BAT-positive participants (P = 0.022).

Conclusions: Tscv correlated positively with EE and was also significantly correlated with SUV after cold exposure. Both IRT and MR FF are promising methods to study BAT activity noninvasively.

Trial registration: ClinicalTrials.gov NCT02964442.

© 2019 The Authors. Obesity published by Wiley Periodicals, Inc. on behalf of The Obesity Society (TOS).

Figures

Figure 1
Figure 1
Representative images of a brown adipose tissue (BAT)–positive participant after cold exposure and capsinoid ingestion. (A,B,C) T2‐weighted anatomical image showing the supraclavicular brown adipose tissue (sBAT), the fat fraction (FF) map in which sBAT is highlighted (color scale shows values of FF in percentages), and the fluorine‐18 fluorodeoxyglucose (18F‐FDG) positron emission tomography (PET) map with a color scale showing standardized uptake values (SUV). (D) PET overlaid on the magnetic resonance (MR) image. (E) Infrared thermography (IRT) map with a color bar showing the temperature in degrees Celsius. (F) 2D projected PET image overlaid on the MR image, with the regions of interest (ROI) showing the maximum glucose uptake within sBAT. (G) Wrapped IRT image on the PET‐MR image, with ROI showing the maximum temperature within sBAT. (H) Overlaid images of IRT and PET‐MR highlighting the maximum glucose uptake (red) and hot (yellow) regions within sBAT.[Colour figure can be viewed at http://wileyonlinelibrary.com]
Figure 2
Figure 2
Correlation between (A) standardized uptake value (SUV) and (B) fat fraction (FF) with duration of cold exposure in 18 participants. (C) Correlation between SUV and FF after adjustment for cold exposure duration and body weight in 18 participants.
Figure 3
Figure 3
Correlations between the positron emission tomography (PET) mean standardized uptake value (SUV) and the (A) infrared thermography (IRT) maximum anterior supraclavicular temperature (Tscv max) and (B) Tscv max change from baseline (∆ Tscv max) in PET brown adipose tissue (BAT)–positive participants (n = 12).

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