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. 2016 Aug 17;16:22. doi: 10.1186/s40644-016-0084-2

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© The Author(s). 2016

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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Fig. 7 — Patients with SDHB-related metastatic PGL showing extensive brown adipose tissue above and below the diaphragm on F-18 FDG PET/CT due to high circulating catecholamines (serum normetadrenaline 18 000 pmol/L, normal <900). F-18 FDG MIP (left) and axial fused PET/CT (bottom) and MIBG (right). The peri-nephric and, to a lesser extent central para-vertebral distribution is characteristic of PCC/PGL-related brown fat activation. Ga-68 DOTATATE (middle) clearly demonstrated an Organ of Zuckerkandl primary and several osseous metastases (botttom middle and bottom right), and is not subject to this physiologic artefact. As well as masking potential primary tumour sites along the sympathetic chain, the “sink effect” in brown fat limits availability of tracer for uptake in tumour sites