RSNA: FDG PET/CT Detects Regional Declines in Brain Metabolism in Patients with 'Chemo Brain'

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(ChemotherapyAdvisor) – Regional declines in brain metabolism measured with functional neuroimaging with 18-Fluorodeoxyglucose positron-emission tomography/computed tomography (FDG PET/CT) are associated with ‘chemo brain' symptoms in breast cancer patients, according to a study presented at the Radiological Society of North America (RSNA)'s 2012 Scientific Assembly and Annual Meeting in Chicago, IL.

“This research provides statistically significant data evaluating the use of 18F FDG PET-CT as a diagnostic tool for the chemobrain phenomenon, facilitating clinical diagnosis and treatment,” said lead author Rachel A. Lagos, D.O., a diagnostic radiology resident at West Virginia University School of Medicine in Morgantown, WV.

The chemo brain phenomenon “is described as ‘mental fog' and ‘loss of coping skills' by patients who receive chemotherapy,” explained Dr. Lagos.

The term has been used for more than 20 years to describe the common patient complaint, she said.

Previous anatomic magnetic resonance imaging (MRI) studies had revealed modest changes in brain volume following chemotherapy. Dr. Lagos's team sought to assess chemo brain using data from 18F-PET-CT staging and restaging images from 128 patients with breast cancer. The images were analyzed using NeuroMim software designed to quantify neurometabolism in 63 brain regions.

Regional declines in brain activity, as measured by neuronal metabolism, were significantly associated with chemo brain symptoms, Dr. Lagos reported.

“In women treated for breast cancer, 18F FDG PET/CT demonstrates statistically significant decreases in regional brain metabolism,” Dr. Lagos reported. “The metabolic changes correlate to chemotherapy regimen, neurological examination and symptoms of chemo brain phenomenon.”

The coauthors plan to follow up with a prospective study to assess “new patients at the time of diagnosis,” Dr. Lagos said. “The prospective study has the potential to establish an understanding of the change in brain neurotransmitters during chemotherapy, which may lead to improved treatment or prevention.”


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