Impact of Depiction of Brown Adipose Tissue (BAT) in Baseline FDG PET/CT on Progression-free Survival in Lymphoma Patients

Zaman, Maseeh Uz; Fatima, Nosheen; Zaman, Sidra; Ahmed, Anwar; Ahmed, Uzair; Ahmed, Minhaj; Zaman, Areeba; Hashmi, Rabiya Fatima

doi:10.31557/APJCP.2026.27.6.2061

Impact of Depiction of Brown Adipose Tissue (BAT) in Baseline FDG PET/CT on Progression-free Survival in Lymphoma Patients

Document Type : Research Articles

Authors

¹ Department of Radiology, Aga Khan University Hospital, Karachi, Pakistan.

² Department of NM and Theranostic, Dow University of Health Sciences, Karachi, Pakistan.

³ Department of Medicine, MedStar Medical Centre, Maryland, USA.

⁴ Students Aga Khan University Medical College, Karachi, Pakistan.

⁵ Department of Medicine, Integris Hospital, Oklahoma, USA.

⁶ Department of Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan.

10.31557/APJCP.2026.27.6.2061

Abstract

Introduction: Brown adipose tissue (BAT) activity seen on 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) has been increasingly recognized as a potential biomarker in various cancers, including lymphomas. The aim of this study was to investigate the correlation between posttreatment survival outcomes and BAT activity depicted in baseline FDG PET/CT scans in lymphoma patients. Material and Method: This retrospective study was conducted at the PET/CT Section of the Department of Radiology, Aga Khan University Hospital, Karachi, Pakistan (2019–2025). The study was granted exemption by the Ethical Review Committee (2024-10630-31016). Patients with lymphoma (Hodgkin’s and non-Hodgkin’s; HL; NHL) whose baseline FDG PET/CT revealed BAT activation were selected. FDG PET/CT scan was acquired using a standardized protocol adopted from the European Association of Nuclear Medicine Guidelines (2015). These patients were followed for a mean of 03 years (range 15–36 months) for survival outcome (progression-free survival; PFS). Results: During the study period, 259 patients with lymphomas (96 HL and 163 HL) who had baseline FDG PET/CT were selected. The cohort included 75% males (n = 194) and 25% females (n = 65), with a median age of 58 years (range: 03-80). BAT activation was identified in 27% of patients (n = 69). A significant association was observed between BAT activation and higher 3-year PFS, with activated BAT patients achieving a survival rate of 78% compared to 58% in those without activation (p < 0.05). Conclusion: Lymphoma patients with activated BAT depicted in their baseline FDG PET/CTs showed longer progression-free survival than those without. This study also emphasizes the need for further evaluation of BAT’s role in metabolism, tumor microenvironment, and long-term prognosis in patients with lymphomas.

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