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PET/MRI Reveals Brain Injury in Young Cancer Survivors

STANFORD, California — Pediatric radiologists at Stanford University have identified a potential breakthrough in diagnosing brain injury among young cancer survivors treated with high-dose methotrexate. Their findings, published in the Journal of Nuclear Medicine on April 4, 2024, suggest that positron emission tomography–magnetic resonance imaging (PET/MRI) scans could play a crucial role in early detection and treatment.

In a pilot study involving 10 children and young adults, researchers utilized PET/MRI to detect traumatic brain injuries characterized by reduced glucose metabolism and blood flow in specific brain regions. Lead author Lucia Baratto, MD, and her team emphasized the significance of these imaging findings in facilitating timely interventions for patients.

High-dose methotrexate therapy, commonly used in pediatric cancer treatment, has been linked to the activation of immune cells in the brain, leading to potentially harmful inflammation over time. The study aimed to diagnose methotrexate-induced brain injury and correlate these findings with cognitive impairment through neurocognitive testing.

Moreover, correlations were found between imaging findings and performance on neurocognitive tests assessing intellectual and executive functioning, as well as memory. These results indicate the potential of PET/MRI as a tool for detecting and quantifying executive functioning issues related to methotrexate therapy.

The authors highlighted the importance of their findings in bridging the gap between methotrexate administration and the degree or location of brain injuries, underscoring the promise of PET/MRI in identifying childhood cancer survivors at risk for long-term neurocognitive problems.

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