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Chemotherapy-associated steatohepatitis was concomitant with epicardial adipose tissue volume increasing in breast cancer patients who received neoadjuvant chemotherapy

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Abstract

Objectives

To investigate the prevalence of chemotherapy-associated steatohepatitis, quantitate the epicardial adipose tissue (EAT) volume in breast cancer patients, and explore the mediating effect of liver fat content on EAT volume in breast cancer patients who received neoadjuvant chemotherapy (NAC).

Methods

From October 2018 to April 2020, patients were retrospectively reviewed and divided into breast cancer non-NAC and NAC groups. The prevalence of chemotherapy-associated steatohepatitis was evaluated through quantitative MRI mDIXON-Quant examinations by using defined proton density fat fraction cutoffs of liver fat. The EAT volume was quantified on chest CT by semi-automatic volume analysis software. Bootstrap analysis was used in the breast cancer NAC group to test the significance of the mediating effect of liver fat content on EAT volume.

Results

A total of 662 breast cancer patients (non-NAC group: 445 patients; NAC group: 217 patients) were included. The prevalence of chemotherapy-associated steatohepatitis in the NAC group was significantly higher than the prevalence of hepatic steatosis in the non-NAC group (42.8% vs. 33.3%, p < 0.001). EAT volume was measured in 561 of 662 breast cancer patients, and was significantly higher in the NAC group than in the non-NAC group (137.26 ± 53.48 mL vs. 125.14 ± 58.77 mL, p = 0.020). In the breast cancer NAC group, the indirect effect of liver fat content on EAT volume was 2.545 (p < 0.001), and the contribution rate to the effect was 69.1%.

Conclusions

EAT volume was significantly higher in the BC-NAC group than in the BC-non-NAC group.

Key Points

• The prevalence of CASH was as high as 42.8% in BC patients.

• NAC significantly increased the EAT volume in BC patients.

• The liver fat content caused the change of EAT volume through mediating effect.

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Abbreviations

BC:

Breast cancer

BMI:

Body mass index

CASH:

Chemotherapy-associated steatohepatitis

CVD:

Cardiovascular disease

EAT:

Epicardial adipose tissue

ICC:

Intraclass correlation coefficient

MRI:

Magnetic resonance imaging

NAC:

Neoadjuvant chemotherapy

NAFLD:

Nonalcoholic fatty liver disease

PDFF:

Proton density fat fraction

ROI:

Region of interest

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Acknowledgements

We thank the study participants and referring technicians for their participation in this study. We acknowledge the support of Xiaoyue Zhang from Siemens scientific research.

Funding

This study has received funding by the Natural Science Foundation of Chongqing municipality (cstc2021jcyj-msxmX0387), the Medical Scientific Research Project of Chongqing Municipal Health Commission (2022WSJK027), and the 2021 SKY Imaging Research Fund of the Chinese International Medical Foundation (Z-2014-07-2101).

Author information

Author notes

  1. Xiaoxia Wang and Yuchuan Tan contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, No.181 Hanyu Road, Shapingba District, Chongqing, 400030, People’s Republic of China

    Xiaoxia Wang, Yuchuan Tan, Daihong Liu, Hesong Shen, Yong Tan, Lei Wang, Yipeng Zhang, Xin Ma & Jiuquan Zhang

  2. Department of Breast Cancer Center, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, 400030, People’s Republic of China

    Yongchun Deng & Xiaohua Zeng

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  1. Xiaoxia Wang
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Correspondence to Xiaohua Zeng or Jiuquan Zhang.

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Guarantor

The scientific guarantor of this publication is Jiuquan Zhang, from the Department of Radiology, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, Chongqing, People’s Republic of China (zhangjq_radiol@foxmail.com).

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The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

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Wang, X., Tan, Y., Liu, D. et al. Chemotherapy-associated steatohepatitis was concomitant with epicardial adipose tissue volume increasing in breast cancer patients who received neoadjuvant chemotherapy. Eur Radiol 32, 4898–4908 (2022). https://doi.org/10.1007/s00330-022-08581-1

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