Frontal and anterior temporal hypometabolism post chemoradiation in head and neck cancer: A real‐world PET study

Background and Purpose Adverse neurological effects after cancer therapy are common, but biomarkers to diagnose, monitor, or risk stratify patients are still not validated or used clinically. An accessible imaging method, such as fluorodeoxyglucose positron emission tomography (FDG PET) of the brain...

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Bibliographic Details
Published in:Journal of neuroimaging 2024-03, Vol.34 (2), p.211-216
Main Authors: Bishay, Steven, Robb, W. Hudson, Schwartz, Trent M., Smith, David S., Lee, Lok Hin, Lynn, Cynthia J., Clark, Tammy L., Jefferson, Angela L., Warner, Jeremy L., Rosenthal, Eben L., Murphy, Barbara A., Hohman, Timothy J., Koran, Mary Ellen I.
Format: Article
Language:English
Subjects:
adverse effects
Biomarkers
Brain
Cancer
Cancer therapies
chemobrain
chemoradiation
Chemoradiotherapy
chemotherapy‐related cognitive impairment
Glucose
Glucose metabolism
Head
Head & neck cancer
Hypometabolism
Image acquisition
Metabolism
Neck
Neuroimaging
PET imaging
Positron emission
Positron emission tomography
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Summary:Background and Purpose Adverse neurological effects after cancer therapy are common, but biomarkers to diagnose, monitor, or risk stratify patients are still not validated or used clinically. An accessible imaging method, such as fluorodeoxyglucose positron emission tomography (FDG PET) of the brain, could meet this gap and serve as a biomarker for functional brain changes. We utilized FDG PET to evaluate which brain regions are most susceptible to altered glucose metabolism after chemoradiation in patients with head and neck cancer (HNCa). Methods Real‐world FDG PET images were acquired as standard of care before and after chemoradiation for HNCa in 68 patients. Linear mixed‐effects voxelwise models assessed changes after chemoradiation in cerebral glucose metabolism quantified with standardized uptake value ratio (SUVR), covarying for follow‐up time and patient demographics. Results Voxelwise analysis revealed two large clusters of decreased glucose metabolism in the medial frontal and polar temporal cortices following chemoradiation, with decreases of approximately 5% SUVR after therapy. Conclusions These findings provide evidence that standard chemoradiation for HNCa can lead to decreased neuronal glucose metabolism, contributing to literature emphasizing the vulnerability of the frontal and anterior temporal lobes, especially in HNCa, where these areas may be particularly vulnerable to indirect radiation‐induced injury. FDG PET shows promise as a sensitive biomarker for assessing these changes.
ISSN:1051-2284
1552-6569
DOI:10.1111/jon.13181