Abstract：Objective: To investigate the impact of fever and chemotherapy on human brain metabolism and function by using 18F-FDG PET/CT. Methods: Brain images of 18F-FDG PET/CT from 28 patients with fever of unknown origin(FUO), 26 with recent chemotherapy and 31 with negative PET/CT examination(as the control group) were retrospectively studied. On PET/CT images, the maximum standardized uptake value(SUVmax) of cortex and basal ganglia were measured, and ratio of cortex to basal ganglia SUVmax(Rc/b-SUVmax) was calculated, and FDG uptake changes in patients with fever or chemotherapy were also analyzed by using an optimized voxel-based statistical parametric mapping(SPM). Mini-mental state examination(MMSE) was used to evaluate whether fever and chemotherapy can lead to changes in the cognitive function. The cerebral uptake of 18F-FDG in patients with FUO or patients with chemotherapy-treatment was compared with the control group, as well as compared between the patients with FUO and the patients with chemotherapy-treatment, respectively. Results: Compared with the control group, the cortex SUVmax and basal ganglia SUVmax were significantly decreased both in the patients with FUO(P<0.001, P=0.004) and patients with chemotherapy-treatment(P=0.007, P=0.013), but Rc/b-SUVmax only in patients with FUO(P<0.001). SPM analysis results consistent with the results of semi-quantitative analysis. It was found that patients with FUO has a more decreased FDG uptake on cortex, comparing to patients with chemotherapy treatment(P=0.015), and MMSE scores were lower than the control group(P=0.004). Conclusion: Both fever and chemotherapy could bring about a diffuse reduce in cerebral glucose metabolism. Decreased uptake of FDG in cerebral cortex is more obvious in patients with a long time fever, and it may lead to a cognitive dysfunction.
袁婷婷，王 茜，李 原，郑朋腾. 18F-FDG PET/CT显像探讨发热及化疗对脑代谢的影响[J]. 中国临床医学影像杂志, 2018, 29(7): 457-460.
YUAN Ting-ting, WANG Qian, LI Yuan, ZHENG Peng-teng. Investigation of effects of fever and chemotherapy on brain metabolism with 18F-FDG PET/CT imaging. JOURNAL OF CHINA MEDICAL IMAGING, 2018, 29(7): 457-460.
[1]Vanderschueren S, Biondo ED, Ruttens D, et al. Inflammation of unknown origin versus fever of unknown origin: two of a kind[J]. Eur J Intern Med, 2009, 20(4): 415-418.
[2]徐梅，牛荣，邵小南，等. Scenium软件研究不同性别正常人脑葡萄糖代谢随年龄变化的规律[J]. 中国医学影像学杂志，2014，22（9）：659-663.
[3]Lomholt RK, Jürgensen KS. The mini-mental state examination in screening of cognitive dysfunction and dementia[J]. Ugeskr Laeger, 1998, 160(50): 7251-7254.
[4]Sorokin J, Saboury B, Ahn JA, et al. Adverse functional effects of chemotherapy on whole-brain metabolism: a PET/CT quantitative analysis of FDG metabolic pattern of the “chemo-brain”[J]. Clin Nucl Med, 2014, 39(1): e35-39.
[5]Horky LL, Gerbaudo VH, Zaitsev A, et al. Systemic chemotherapy decreases brain glucose metabolism[J]. Ann Clin Transl Neurol, 2014, 1(10): 788-798.
[6]Nunneley SA, Martin CC, Slauson JW, et al. Changes in regional cerebral metabolism during systemic hyperthermia in humans[J]. J Appl Physiol, 2002, 92(2): 846-851.
[7]Baudino B, D’agata F, Caroppo P, et al. The chemotherapy long-term effect on cognitive functions and brain metabolism in lymphoma patients[J]. Q J Nucl Med Mol Imaging, 2012, 56(6): 559-568.
[8]Silverman DH, Dy CJ, Castellon SA, et al. Altered frontocortical, cerebellar, and basal ganglia activity in adjuvant-treated breast cancer survivors 5-10 years after chemotherapy[J]. Breast Cancer Res Treat, 2007, 103(3): 303-311.
[9]de Ruiter MB, Reneman L, Boogerd W, et al. Cerebral hyporesponsiveness and cognitive impairment 10 years after chemotherapy for breast cancer[J]. Hum Brain Mapp, 2011, 32(8): 1206-1219.
[10]Koppelmans V, Breteler MM, Boogerd W, et al. Neuropsychological performance in survivors of breast cancer more than 20 years after adjuvant chemotherapy[J]. J Clin Oncol, 2012, 30(10): 1080-1086.
[11]Jansen CE, Cooper BA, Dodd MJ, et al. A prospective longitudinal study of chemotherapy-induced cognitive changes in breast cancer patients[J]. Support Care Cancer, 2011, 19(10): 1647-1656.
[12]Collins B, Mackenzie J, Tasca GA, et al. Persistent cognitive changes in breast cancer patients 1 year following completion of chemotherapy[J]. J Int Neuropsychol Soc, 2014, 20(4): 370-379.
[13]Simó M, Root JC, Vaquero L, et al. Cognitive and brain structural changes in a lung cancer population[J]. J Thorac Oncol, 2015, 10(1): 38-45.
[14]Deprez S, Amant F, Smeets A, et al. Longitudinal assessment of chemotherapy-induced structural changes in cerebral white matter and its correlation with impaired cognitive functioning[J]. J Clin Oncol, 2012, 30(3): 274-281.
[15]Gaoua N, Racinais S, Grantham J, et al. Alterations in cognitive performance during passive hyperthermia are task dependent[J]. Int J Hyperthermia, 2011, 27(1): 1-9.
[16]Jiang Q, Yang X, Liu K, et al. Hyperthermia impaired human visual short-term memory: An fMRI study[J]. Int J Hyperthermia, 2013, 29(3): 219-224.
[17]Liu K, Li B, Qian S, et al. Altered interhemispheric resting state functional connectivity during passive hyperthermia[J]. Int J Hyperthermia, 2015, 31(8): 840-849.
