Adverse Functional Effects of Chemotherapy on Whole-Brain Metabolism: A PET/CT Quantitative Analysis of FDG Metabolic Pattern of the “Chemo-Brain”

PURPOSEWith its unique ability to assess function through metabolism, FDG PET may provide key insight into the adverse effects of chemotherapy on the brain by shedding light on its cognitive and psychological consequences, a well-known phenomenon in cancer patients who undergo such treatments. PATIENTS AND METHODSTwenty-one patients with untreated non-Hodgkin lymphoma and no involvement of the central nervous system were selected from an existing database for this investigation. An adaptive threshold imaging software called ROVER was used to analyze and quantify FDG PET scans for assessing whole-brain metabolism. A 3D spherical region of interest was drawn surrounding the cerebral cortex, excluding subcortical and non-cortical areas. RESULTSWe noted a mean reduction of 1308.86 ± 394.74 SUV-cc (P = 0.03) in the whole-brain cortical glycolysis after standard chemotherapy, which translated to a decrease of 16.9 ± 5.04% (P = 0.03) in the measured structures. CONCLUSIONThese results demonstrate the potential role of such adaptive quantitative techniques in studying underlying biological effects of chemotherapy and offer a promising avenue for future research in this field.