A PET-CT Study Of Cerebral Glucose Metabolism Change Between Pre And Post Chemotherapy Cancer Survivals

Backgroud and objectsThis article reviewed the application of PET-CT on cancer-related cognitive and analyzed the changes of cerebral glucose metabolism between pre and post chemotherapy on the patients with breast cancer and lymphoma by PET in order to compare the effects of tumor and chemotherapy.MethodsTwelve breast cancer patients underwent twice ¹⁸F-FDG PET-CT scans with chemotherapy of CE/CEF/CET and seventy lymphoma patients underwent triple?baseline,three cycles,six cycles post chemotherapy?PET-CT scans with the treatment of CHOP or R-CHOP.The PET cerebral images were drawn to standardized ROI automatically by the software NeuroQ.The calculation of average pixel value in each region/whole brain ratios would be analyzed with fifty healthy controls by T/Z test.The brain regions with significant difference?P<0.05?would be identified and discussed.ResultsThere were total 26 brain regions with significant difference compared with healthy controls at baseline PET scan in breast cancer patients,involving FDG hypometabolism in the left inf and mid frontal lobe,right medial frontal lobe,bilateral cerebellum,bilateral temporal lobe and FDG hypermetabolism in the left sensorimotor cortex,bilateral frontal lobe,left lateral temporal lobe,left caudate nucleus and right primary visual cortex.There were total 24 brain regions with significant difference compared with healthy controls at post-chemotherapy PET scan in breast cancer patients,involving FDG hypometabolism in the right medial frontal lobe,right caudate nucleus,right anterior temporal lobe,bilateral cerebellum and FDG hypermetabolism in the left sensorimotor cortex,left middle frontal lobe,left cingulate gyrus and right visual cortex.There were total 95 brain regions with significant difference compared with healthy controls at baseline PET scan in lymphoma patients,involving FDG hypometabolism in the left sensorimotor cortex,bilateral sup frontal lobe,left inf frontal lobe and right Broca's area,part of bilateral cingulate gyrus,right caudate nucleus,partial bilateral temporal lobe,cerebellum and FDG hypermetabolism in the left Broca's area,bilateral visual cortex,bilateral thalamus,midbrain and pons.There were total 26 brain regions with significant difference compared with healthy controls at three cycles post chemotherapy PET scan,involving FDG hypometabolism in partial bilateral frontal lobe,right posterior cingulate,left lateral temporal lobe and FDG hypermetabolism in bilateral visual cortex,bilateral thalamus,bilateral temporal lobe,midbrain and pons.There were total 7 brain regions with significant difference compared with healthy controls at six cycles post chemotherapy PET scan,involving FDG hypometabolism in right posterior cingulate gyrus,the right parietal temporal lobe and FDG hypermetabolism in right visual cortex and left thalamus.ConclusionThe number of abnormal brain regions in post-chemotherapy patients with breast cancer were similar to those pre-chemotherapy but the range changed.So the cancer status and CE/CET/CEF chemotherapy may affect the brain function but the mechanism should be different.The number of abnormal brain regions decreased and the range was reduced in post-chemotherapy patients with lymphoma.Therefore,CHOP/R-CHOP therapy has no significant effect on the brain function.Abnormal brain regions before chemotherapy may be related to tumor burden and special emotional state,such as depression and fatigue.