title: Frontal hypometabolism in elderly breast cancer survivors determined by [(18)F]fluorodeoxyglucose (FDG) positron emission tomography (PET): a pilot study.
abstract: OBJECTIVE
  The term "chemobrain" is sometimes used to denote deficits in neuropsychological functioning that may occur as a result of cancer treatment. As breast cancer survivors now commonly reach late life, it is not known whether previous exposure to chemotherapy may affect long-term risk for cognitive impairment. To help address this concern, this study tested whether successfully surviving chemotherapy earlier in life was associated with later differences in brain metabolic function as an older adult compared to controls. This question was examined using positron emission tomography measures of brain glucose metabolism in elderly women cancer survivors.
  
  
  METHODS
  Breast cancer survivors (N = 10), currently free of recurrent cancer and without a diagnosis of a cognitive disorder, were compared to matched healthy controls (N = 10). All subjects were imaged at rest with [(18)F]fluorodeoxyglucose. Images were analyzed semi-quantitatively using the Alzheimer's Discrimination Tool and a volume of interest-based approach derived from co-registered magnetic resonance imaging.
  
  
  RESULTS
  Relative [(18)F]fluorodeoxyglucose uptake (normalized to global) was significantly lower in the survivors compared with control subjects in bilateral orbital frontal regions, consistent with differences between the groups in cognition and executive function (i.e., Trail Making Test, Part B and mini-mental state examination) and despite no significant differences with respect to age, education, intelligence, or working memory. None of the survivors and only one control manifested a global positron emission tomography score consistent with an Alzheimer's disease metabolic pattern.
  
  
  CONCLUSIONS
  Breast cancer survivors treated with chemotherapy may manifest long-term changes in brain glucose metabolism indicative of subtle frontal hypometabolism, a finding consistent with results from neuropsychological testing and other imaging modalities.
authors.affiliation: Department of Radiology, University of Iowa Carver College of Medicine, Iowa City, IA, USA; Positron Emission Tomography Imaging Center, Department of Radiology, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
authors.forename: Laura L Boles
authors.initials: LL
authors.lastname: Ponto
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Menda
authors.forename: Vincent A
authors.initials: VA
authors.lastname: Magnotta
authors.forename: Torricia H
authors.initials: TH
authors.lastname: Yamada
authors.forename: Natalie L
authors.initials: NL
authors.lastname: Denburg
authors.forename: Susan K
authors.initials: SK
authors.lastname: Schultz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy*; D003071:Cognition / Q000502:physiology; D056344:Executive Function / Q000502:physiology; D005260:Female; D019788:Fluorodeoxyglucose F18; D005625:Frontal Lobe / Q000187:drug effects / Q000378:metabolism*; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D009483:Neuropsychological Tests; D010865:Pilot Projects; D049268:Positron-Emission Tomography / Q000379:methods; D019275:Radiopharmaceuticals; D017741:Survivors
chemical_list: D000970:Antineoplastic Agents; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D005947:Glucose
keywords: FDG; [18F]fluorodeoxyglucose; brain metabolism; breast cancer; chemobrain