Functional Imaging of Chemobrain

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification for enrollments starting after February 10, 2026:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Nuclear Medicine Technology: 2.00
Procedures: 2.00
Other Imaging Procedures: 2.00

Radiation Therapy: 0.25
Procedures: 0.25
Treatments: 0.25

Outline

1. Introduction
2. Clinical Features of CRCI
3. CRCI Physiopathologic Basis
4. Search Strategy
5. Results
   1. Chemotherapeutic Agents and CRCI
   2. PET and SPECT Imaging of CRCI
   3. SPECT Tracers for CRCI Imaging
   4. ¹⁸F-FDG PET Imaging in CRCI
   5. PET with Tracers Other Than ¹⁸F-FDG: Translocator Protein (TSPO) Ligands for CRCI Imaging
6. Conclusions and Future Outlook

Objectives

Upon completion of this course, students will:

1. know the meaning for the acronym CRCI
2. know the symptoms by which CRCI can be characterized
3. identify the suspected causes for CRCI at a molecular level
4. be familiar with the cognitive domains and abilities more commonly involved in CRCI
5. understand how CRCI can affect distinct populations of cancer patients differently
6. know the various methods of cognitive impairment assessment for patients who have undergone chemotherapy
7. know what can potentially be involved with chemotherapy induced encephalopathy
8. know the culminating effects of chemotherapy drug-induced damage to neurons
9. understand how chemotherapy can affect a patient through various modifications in brain tissue
10. understand the outputs from the PubMed / Medline database searches that were conducted according to the PRISMA guidelines
11. be familiar with the types of studies that were considered in the two PubMed / Medline database searches that were referenced in the article
12. be familiar with the search restrictions imposed in the two PubMed / Medline database searches that were referenced in the article
13. understand the extracted data types for the two PubMed / Medline database searches reference in the article
14. be familiar with the studies including PET and SPECT imaging for CRCI
15. understand the heterogeneity in study design for the studies found in the PubMed / Medline database searches for assessing the effects of various chemotherapeutic agents on cognitive function
16. identify the focus condition for the majority of the studies found in the PubMed / Medline database search to evaluate chemotherapeutic agents’ effects on cognitive function
17. know the number of patients with cognitive function decline after chemotherapy within the selected studies from the PubMed / Medline database search to evaluate chemotherapeutic agents’ effects on cognitive function
18. specify the tumor types evaluated by the studies selected from the PubMed / Medline database search to evaluate PET and SPECT imaging of CRCI
19. understand the breakdown percentages of SPECT and PET/CT studies used in the studies selected from the PubMed / Medline database search to evaluate PET and SPECT imaging of CRCI
20. know PET evaluation methods used for studies selected from the PubMed / Medline database search to evaluate PET and SPECT imaging of CRCI
21. know the limitation(s) of SPECT ^99mTc-hexamethyl-propylene-amine oxime (HMPAO) in the assessment of cerebral blood flow
22. know the phases of ^99mTc HMPAO SPECT used by Véra et al. paper to investigate changes in cerebral blood flow
23. know what the SPECT results were correlated with in the Véra et al. paper
24. indicate the meaning for the acronym DAT in molecular imaging of DATs through SPEC
25. know what molecular imaging of DATs through SPECT has been clinically used to diagnose
26. for the study by Vitor et al., know the areas of the brain in which the ^99mTc-TRODAT-1 tracer concentration was significantly less in breast cancer patients experiencing CRCI than in healthy controls
27. understand the responsiveness to levodopa for patients developing parkinsonism after chemotherapy
28. know what the brain uses as its sole source of energy under normal conditions
29. recognize the considerations to be made when utilizing ¹⁸F-FDG PET imaging of the brain
30. understand the reported impact of chemotherapy on brain metabolism in Hodgkin lymphoma as concluded by the authors cited 2015 study for the potential role of ¹⁸F-FDG in patients with CRCI
31. be familiar with the findings of the Shrot et al. study on ¹⁸F-FDG uptake in post-chemotherapy pediatric patients
32. understand the reduction of cerebral cortical metabolism after chemotherapy found in a study from Sorokin et al. of patients with non-Hodgkin lymphoma
33. understand the reasons for TSPO emerging as a molecular imaging target for inflammation
34. understand comparison of patient cohorts in the Schroyen et al. study
35. recognize the conclusions drawn by the authors of the article