Rachel Anne Lagos DO, Presenter: Nothing to Disclose

Gary Marano MD, Abstract Co-Author: Nothing to Disclose

Judith Stark Schreiman MD, Abstract Co-Author: Nothing to Disclose

Marc Haut PHD, Abstract Co-Author: Nothing to Disclose

Jame Abraham MD, Abstract Co-Author: Nothing to Disclose

Gary Hobbs PhD, Abstract Co-Author: Nothing to Disclose

Shamsuddin Virani MD, Abstract Co-Author: Nothing to Disclose

This IRB-approved retrospective pilot study of eighty PET-CT examinations for breast cancer staging and restaging investigates whether there are significant changes in brain metabolism following neoadjuvant chemotherapy.

The study scrutinizes fluorine-18 fluorodeoxyglucose (F-18 FDG) metabolism on breast cancer staging and restaging PET-CT examinations. Patients reviewed in this study were diagnosed with breast cancer between 2004 and 2009 at the Mary Babb Randolph Cancer Center and subsequently received neoadjuvant chemotherapy. A PET Center database search provided the initial (staging) PET-CT as well as a subsequent (restaging) PET-CT examiantion for forty patients. The NeuroMim® software analysis program compares a comprehensive database of physiologic brain anatomy and metabolism with the perfusion of fluorine-18 labeled fluorodeoxyglucose exhibited in each PET-CT examination. For each patient, two examinations at twelve month intervals are analyzed. Comparison is conducted in sixty-three defined brain regions. The data set from each staging PET-CT is then compared to the data set from its respective restaging PET-CT.

Data anaylsis using the signed-rank test concludes that the collective Z-score values do change between the staging and restaging PET-CT examinatons. When data analysis is applied to the individual brain regions, two regions show statistically significant decreases in brain metabolism following chemotherapy. These are the Inferior Frontal Gyrus Pars Opercularis and the Angular Gyrus, the regions attributed with executive function, calculation and cognition. Several additional regions show p-values between 0.05 and 0.10, which indicate "trending". These trending regions may demonstrate statistically significant p-values <0.05 once the number of analyzed data sets is increased.

The Inferior Frontal Gyrus Pars Opercularis (p-value = 0.0483) and the Angular Gyrus (p-value = 0.0396) show statistically significant decreases in glucose metabolism subsequent to neoadjuvant chemotherapy for breast cancer.

Preliminary results suggest that F-18 FDG PET-CT is possibly a valid diagnostic tool for documenting cognitive decline or "chemo brain" in breast cancer patients receiving chemotherapy.

Lagos, R, Marano, G, Schreiman, J, Haut, M, Abraham, J, Hobbs, G, Virani, S, Pilot Study Utilizing 18-F FDG PET-CT to Investigate Brain Metabolic Changes in Women Treated for Breast Cancer.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11005869.html