Glial activation positron emission tomography imaging in radiation treatment of breast cancer brain metastases

Sawyer Rhae Badiuk; Jonathan D. Thiessen; Saman Maleki Vareki; Paula J. Foster; Jeff Z. Chen; Eugene Wong

Physics and Imaging in Radiation Oncology (Jan 2022)

Glial activation positron emission tomography imaging in radiation treatment of breast cancer brain metastases

Sawyer Rhae Badiuk,
Jonathan D. Thiessen,
Saman Maleki Vareki,
Paula J. Foster,
Jeff Z. Chen,
Eugene Wong

Affiliations

Sawyer Rhae Badiuk: Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON N6A 3K7, Canada; Corresponding author at: Department of Medical Biophysics, University of Western Ontario, London ON, Canada.
Jonathan D. Thiessen: Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON N6A 3K7, Canada; Department of Medical Imaging, University of Western Ontario, London, ON N6A 3K7, Canada; Imaging Program, Lawson Health Research Institute, London, ON N6A 5W9, Canada
Saman Maleki Vareki: Cancer Research Laboratory Program, Lawson Health Research Institute, London, ON N6A5 W9, Canada; Department of Pathology and Laboratory Medicine, University of Western Ontario, London, ON N6A 3K7, Canada; Department of Oncology, Division of Experimental Oncology, University of Western Ontario, London, ON N6A 3K7, Canada
Paula J. Foster: Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON N6A 3K7, Canada; Imaging Research Laboratories, Robarts Research Institute, London, ON N6A 5B7, Canada
Jeff Z. Chen: Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON N6A 3K7, Canada; London Regional Cancer Program, London Health Sciences Centre, London, ON N6A 5W9, Canada
Eugene Wong: Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON N6A 3K7, Canada; Department of Physics and Astronomy, University of Western Ontario, London, ON N6A 3K7, Canada

Journal volume & issue: Vol. 21
pp. 115 – 122

Abstract

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Brain metastases affect more breast cancer patients than ever before due to increased overall patient survival with improved molecularly targeted treatments. Approximately 25–34% of breast cancer patients develop brain metastases in their lifetime. Due to the blood–brain barrier (BBB), the standard treatment for breast cancer brain metastases (BCBM) is surgery, stereotactic radiosurgery (SRS) and/or whole brain radiation therapy (WBRT). At the cost of cognitive side effects, WBRT has proven efficacy in treating brain metastases when used with local therapies such as SRS and surgery. This review investigated the potential use of glial activation positron emission tomography (PET) imaging for radiation treatment of BCBM. In order to put these studies into context, we provided background on current radiation treatment approaches for BCBM, our current understanding of the brain microenvironment, its interaction with the peripheral immune system, and alterations in the brain microenvironment by BCBM and radiation. We summarized preclinical literature on the interactions between glial activation and cognition and clinical studies using translocator protein (TSPO) PET to image glial activation in the context of neurological diseases. TSPO-PET is not employed clinically in assessing and guiding cancer therapies. However, it has gained traction in preclinical studies where glial activation was investigated from primary brain cancer, metastases and radiation treatments. Novel glial activation PET imaging and its applications in preclinical studies using breast cancer models and glial immunohistochemistry are highlighted. Lastly, we discuss the potential clinical application of glial activation imaging to improve the therapeutic ratio of radiation treatments for BCBM.

Published in Physics and Imaging in Radiation Oncology

ISSN: 2405-6316 (Online)
Publisher: Elsevier
Country of publisher: Ireland
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine; Medicine: Internal medicine: Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Website: https://www.journals.elsevier.com/physics-and-imaging-in-radiation-oncology/

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