The Brain Metabolic Change in Chronic Cancer Pain Patient: FDG PET Image Study

Study Overview
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Brief Summary
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Cancer pain deteriorated in quality of life and related with numerous psychosocial problems. Over the one third of cancer patient suffered from moderate to severe cancer pain, even under adequate pain management. The 18F-fluoro-2-deoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) images can provide quantitative results in clinical oncology. As a functional neuroimaging, the PET evidently provided anatomical activated regions, size, and spatial extent information. In this study, we use FDG-PET to investigate changes concerning the glucose metabolism in the brain with or without cancer pain. Therefore, we may provide useful information to treatment target in cancer pain patients.

Detailed Description
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Overall, cancer incidence has decreased and the rate of cancer deaths in both men and women has also significantly declined among both men and women in all site.However, the prevalence of chronic pain is 28.2%, ranging from 22.5% to 35.4%, depending on the location of the primary tumor, and neuropathic characteristics were observed in 19.9% of patients with chronic cancer pain. Despite numerous studies on cancer pathogenesis and diagnosis, few reports have demonstrated the brain mechanism underlying cancer pain. One study used resting functional magnetic resonance imaging (fMRI) to identify the changes in the functional brain network of chronic bone cancer pain mice under anesthesia. Cancer-induced bone pain (CIBP) might alter resting state activity of the cingulate cortex, prefrontal cortex (PFC) and ventral striatum, indicating a strong affective component of the CIBP mice.In imaging studies of human patients with cancer, patients with chronic cancer pain exhibited activation in the PFC. The 18F-fluoro-2-deoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) images can provide quantitative results in clinical oncology.Owing to the higher glucose metabolic rate in the brain, brain FDG-PET images are not routinely used in the clinical setting. However, several studies have demonstrated functional brain changes in human pain condition.In this study, we use FDG-PET to investigate changes concerning the glucose metabolism in the brain with or without cancer pain.

Official Title
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The Brain Metabolic Change in Chronic Cancer Pain Patient: FDG PET Image Study

Conditions
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Cancer Pain

Intervention / Treatment
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* Diagnostic Test: FDG PET


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Cancer patients who scheduled whole body FDG-PET image scan for clinically indicated. Age > 20 Exclusion Criteria: Unable to complete questionnaires. Prior evidence of brain metastases.

Ages Eligible for Study
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Minimum Age: 20 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| with cancer pain<br>head and neck and esophageal cancer patients. with cancer pain | Diagnostic Test: FDG PET<br>* Cancer patients who scheduled whole body FDG-PET image scan for clinically indicated.<br>|
| without cancer pain<br>head and neck and esophageal cancer patients. without cancer pain=30 | Diagnostic Test: FDG PET<br>* Cancer patients who scheduled whole body FDG-PET image scan for clinically indicated.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Brain metabolism change | The FDG-PET of Standardized uptake values (SUVs) were calculated for each voxel in the reconstructed images to investigate changes concerning the glucose metabolism in the brain with or without cancer pain | 12 months |