Amyloid Plaque Deposition in Chemotherapy-Induced Cognitive Impairment
Status:
Recruiting
Trial end date:
2022-01-01
Target enrollment:
Participant gender:
Summary
The initial goal of the investigators interdisciplinary group of imagers, oncologists,
neurologists, neuro-psychologists, and biostatisticians is to obtain proof of concept pilot
data for eventual submission of a National Cancer Institute Quick-Trial for Imaging and
Image-Guided Interventions: Exploratory Grant (R10) depending on the results of this pilot
study.
The overall objective is to use [18F]Flutemetamol, FDG-PET, and MRI to better understand
CICI, which effects up to 16 -50% of individuals receiving long-term adjuvant
chemotherapy.2,3 To date there have been few studies examining this problem using
multi-modality imaging techniques to better understand this complex and significant problem.
FDG-PET and MRI are routinely used in clinical practice for the evaluation of cognitive
dysfunction in older populations complaining of memory dysfunction. It is well recognized
that FDG-PET can assist with the differentiation and characterization of various cognitive
disorders due to unique patterns of cerebral metabolism caused by various cognitive and
dementia-causing disorders.4-6 FDG-PET has been studied extensively in dementia research and
has a high reliability in detecting Alzheimers disease (AD) many years before it can be
diagnosed reliably using clinical criteria.4
To the investigators knowledge, there has been only a single small study using FDG-PET and
bolus water activation paradigms in cancer patients complaining of memory problems.7 To date,
there have been no studies using [18F]Flutemetamol as a PET imaging agent to assess the
possibility of increased amyloid plaque burden as a potential contributing factor to the
cognitive deficits and complaints seen in patients experiencing CICI. The novel feature of
this project is in the combined use of [18F]Flutemetamol-PET, FDG-PET, and anatomic MRI to
study a poorly understood but common problem: cognitive impairment in breast cancer patients
treated with chemotherapy.
If [18F]Flutemetamol, FDG-PET, and MRI can provide information on the pathophysiology of this
disorder, it will be an important step in better understanding the etiology of this
phenomenon and possibly other conditions resulting in cognitive dysfunction. These imaging
assessments will make it possible to explore any altered changes in cerebral structure,
metabolism, and amyloid deposition that may be responsible for CICI. This may help to predict
which individuals may be affected by this problem and provide information for eventual
therapeutic strategies to treat this common cancer-associated disorder.
This study will use [18F]Flutemetamol and FDG-PET imaging to assess and quantify the amyloid
plaque burden and cerebral glucose metabolism, respectively, in breast cancer patients
suffering from CICI and correlate those findings with structural changes on MRI. The
[18F]Flutemetamol and FDG-PET scans of these study patients will then be compared to two GE
software databases (CortexID-FDG and CortexID-Flutemetamol) which contain scan data from
healthy control individuals to evaluate for abnormalities in cerebral glucose metabolism and
amyloid plaque burden differing from the values expected for individuals in their age range.