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Imaging Cold-Activated Brown Adipose Tissue Using Dynamic T2*-Weighted Magnetic Resonance Imaging and 2-Deoxy-2-[18F]fluoro-D-glucose Positron Emission Tomography

van Rooijen, Bart D. PhD*; van der Lans, Anouk A.J.J. MS; Brans, Boudewijn MD, PhD; Wildberger, Joachim E. MD, PhD*; Mottaghy, Felix M. MD, PhD‡§; Schrauwen, Patrick PhD; Backes, Walter H. PhD*; van Marken Lichtenbelt, Wouter D. PhD

doi: 10.1097/RLI.0b013e31829363b8
Original Articles

Objectives The objective of this study was to explore the use of magnetic resonance imaging (MRI) to identify and quantify active brown adipose tissue (BAT) in adult humans. 2-Deoxy-2-[18F]fluoro-D-glucose (FDG) positron emission tomography (PET) combined with computed tomography was used as a reference method to identify active BAT depots and to guide the MRI data analysis.

Materials and Methods The ethics committee of the institute approved the protocol, and all participants provided written informed consent before participation. Both PET combined with computed tomography and MRI of BAT were performed in 11 healthy volunteers. Brown adipose tissue was activated by cooling the participants using a dedicated water-perfused suit. For the MRI examination of BAT, water-fat imaging and dynamic T2* imaging were performed at an effective temporal resolution of 2 minutes per volume. Water-fat images were derived from a multiecho MRI sequence using the Dixon technique.

Results 2-Deoxy-2-[18F]fluoro-D-glucose–PET identified active BAT in 8 of the 11 participants. Water-fat MRI showed that BAT depots had a fat fraction of 65.2% (7.0%) compared with 81.5% (5.4%) for the subcutaneous white adipose tissue (paired difference of 16.3% [4.9%]; P < 0.05). Dynamic T2* imaging during cold stimulation revealed signal fluctuations that were sensitive to BAT activation. The presence of these components correlated with BAT activation quantified from FDG-PET (r = 0.63; P < 0.05).

Conclusions Although FDG-PET has superior contrast for identifying active BAT, the MRI temporal resolution provides insight in activation dynamics. In addition, the flexibility of MRI allows for simultaneous mapping of tissue fat content and functional responses. The results indicate that MRI is a promising addition to PET for the identification of BAT and its activity responses to stimulation. An MRI-based methodology to quantify BAT activity is a highly desirable step in addressing the role of BAT in obesity disorders.

Supplemental digital content is available in the text.

From the *Department of Radiology, Maastricht University Medical Center, †Department of Human Biology and Nutrition and Toxicology Research Institute Maastricht, Maastricht University, ‡Department of Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands; and §Department of Nuclear Medicine, University Hospital Aachen, Aachen, Germany.

Received for publication November 12, 2012; and accepted for publication, after revision, February 24, 2013.

Supported partly by the Netherlands Organization for Scientific Research (TOP 91209037) to WDvML and by the European Union FP7 project DIABAT (HEALTH-F2-2011-278373).

The authors report no conflicts of interest.

Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (

Reprints: Walter H. Backes, PhD, Department of Radiology, Maastricht University Medical Center, PO Box 5800, 6202 AZ, Maastricht, The Netherlands. E-mail:

© 2013 by Lippincott Williams & Wilkins