With the improvement of cancer survival rates, cancer-related cognitive impairment (CRCI) has become a key complication affecting the quality of life of more than 70% of tumor patients. Its pathogenesis is complex, involving the interaction of multiple factors such as chemotherapy-induced neurotoxicity, neuroinflammation, and metabolic disorders, but the specific imaging features and pathological mechanisms still need to be systematically clarified. By systematically reviewing relevant domestic and foreign literature, this review summarizes the cerebral glucose metabolic characteristics before and after chemotherapy, potential mechanisms, and clinical intervention methods. Understanding the dynamic changes in cerebral glucose metabolism provides an important basis for the early identification and intervention of CRCI. Future research should focus on integrating multimodal PET imaging and radiomics data to develop individualized neuroprotective strategies based on metabolic feature typing, and ultimately promote the transformation of CRCI management from neurotoxicity control to neurofunctional improvement.
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