Impact of prophylactic cranial irradiation and hippocampal sparing on 18F-FDG brain metabolism in small cell lung cancer patients.

Details

Serval ID
serval:BIB_4F5C9655A438
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Impact of prophylactic cranial irradiation and hippocampal sparing on 18F-FDG brain metabolism in small cell lung cancer patients.
Journal
Radiotherapy and oncology
Author(s)
Chammah S.E., Allenbach G., Jumeau R., Boughdad S., Prior J.O., Nicod Lalonde M., Schaefer N., Meyer M.
ISSN
1879-0887 (Electronic)
ISSN-L
0167-8140
Publication state
Published
Issued date
05/2021
Peer-reviewed
Oui
Volume
158
Pages
200-206
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Prophylactic cranial irradiation (PCI) in small-cell lung cancer (SCLC) patients improves survival. However, it is also associated with cognitive impairment, although the underlying mechanisms remain poorly understood. Our study aims to evaluate the impact of PCI and potential benefit of hippocampal sparing (HS) on brain metabolism assessed by <sup>18</sup> F-Fluoro-Deoxy-Glucose Positron Emission Tomography/Computed Tomography ( <sup>18</sup> F-FDG PET/CT).
We retrospectively included 22 SCLC patients. 50% had hippocampal-sparing (HS) PCI. <sup>18</sup> F-FDG PET/CT was performed 144.5 ± 73 days before and 383 ± 451 days after PCI. Brain <sup>18</sup> F-FDG PET scans were automatically segmented in 12 regions using Combined-AAL Atlas from MI-Neurology Software (Syngo.Via, Siemens Healthineers). For all atlas regions, we computed SUV Ratio using brainstem as a reference region (SUVR = SUVmean/Brainstem SUVmean) and compared SUVR before and after PCI, using a Wilcoxon test, with a level of significance of p < 0.05.
We found significant decreases in <sup>18</sup> F-FDG brain metabolism after PCI in the basal ganglia (p = 0.004), central regions (p = 0.001), cingulate cortex (p < 0.001), corpus striata (p = 0.003), frontal cortex (p < 0.001), parietal cortex (p = 0.001), the occipital cortex (p = 0.002), precuneus (p = 0.001), lateral temporal cortex (p = 0.001) and cerebellum (p < 0.001). Conversely, there were no significant changes in the mesial temporal cortex (MTC) which includes the hippocampi (p = 0.089). The subgroup who received standard PCI showed a significant decrease in metabolism of the hippocampi (p = 0.033). Contrastingly, the subgroup of patients who underwent HS-PCI showed no significant variation in metabolism of the hippocampi (p = 0.783).
PCI induced a diffuse decrease in <sup>18</sup> F-FDG brain metabolism. HS-PCI preserves metabolic activity of the hippocampi.
Keywords
Brain/diagnostic imaging, Cranial Irradiation, Fluorodeoxyglucose F18, Hippocampus/diagnostic imaging, Humans, Lung Neoplasms/diagnostic imaging, Lung Neoplasms/radiotherapy, Positron Emission Tomography Computed Tomography, Positron-Emission Tomography, Retrospective Studies, Small Cell Lung Carcinoma/diagnostic imaging, Small Cell Lung Carcinoma/radiotherapy, (18)F-FDG, Brain metabolism, Hippocampal Sparing, PET/CT, Prophylactic cranial irradiation, Small cell lung cancer
Pubmed
Web of science
Create date
16/03/2021 9:17
Last modification date
04/03/2022 6:33
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