Evaluation of the effects of chemotherapy on brain glucose metabolism in children with Hodgkin's lymphoma

Ann Nucl Med. 2019 Aug;33(8):564-569. doi: 10.1007/s12149-019-01363-8. Epub 2019 May 13.

Abstract

Objective: Chemobrain is a recently proposed pathological entity. 18F-FDG PET/CT can show objective abnormalities to explain brain disorders caused by chemotherapy, although no study has investigated these phenomena in children to date. The main objective of the present study was to examine quantitatively the effects of chemotherapy on brain metabolism in a homogeneous population of children treated for Hodgkin's lymphoma using 18F-FDG PET/CT.

Methods: In this retrospective study, we included 20 children, newly diagnosed with Hodgkin's lymphoma, who underwent 18F-FDG PET/CT at initial staging and at least one PET/CT in follow-up. The SPM12 software provided t-maps to show the difference in metabolism between these PET/CTs. The statistical maps were analyzed with xjView software to identify the brain regions associated with the clusters detected.

Results: Altered glucose metabolism was found in the frontal, cingular, and temporoinsular regions after two cycles of chemotherapy. Results in children were compared to a group of 35 adults. For the same statistical threshold, the extent and depth of the metabolic alterations were less in the adult group than in children.

Conclusions: 18F-FDG PET/CT is useful in providing objective data to explain brain disorders caused by chemotherapy. This could lead to better care and should be compared to neuropsychological test results.

Keywords: Chemobrain; Chemofog; FDG PET; Hodgkin’s lymphoma.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use
  • Brain / diagnostic imaging
  • Brain / drug effects*
  • Brain / metabolism*
  • Child
  • Female
  • Fluorodeoxyglucose F18
  • Glucose / metabolism*
  • Hodgkin Disease / diagnostic imaging
  • Hodgkin Disease / drug therapy*
  • Hodgkin Disease / metabolism*
  • Humans
  • Male
  • Middle Aged
  • Positron Emission Tomography Computed Tomography
  • Retrospective Studies
  • Young Adult

Substances

  • Antineoplastic Agents
  • Fluorodeoxyglucose F18
  • Glucose