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Association between FDG uptake in the right ventricular myocardium and cancer therapy-induced cardiotoxicity

  • Original Article
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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

The aim of this study was to investigate changes in myocardial uptake evaluated by oncologic 18F-fluorodeoxyglucose (FDG) PET/CT scans and to determine the relationship between myocardial FDG uptake and cancer therapy-induced cardiotoxicity in breast cancer patients who underwent anthracycline or trastuzumab.

Methods

We reviewed 121 consecutive patients who underwent oncologic FDG PET/CT and echocardiography at baseline and post-therapy with anthracyclines or trastuzumab for breast cancer. Grade in LV wall, uptake pattern in LV wall, and the presence of RV wall uptake were assessed by visual analysis, and the mean SUV in the LV and RV walls and the change of SUV (ΔSUV) between baseline and post-therapy PET/CT were measured by quantitative analysis. Multiple logistic regression analyses were performed to evaluate the association between PET parameters and cardiotoxicity.

Results

Fifteen patients (12%) showed cardiotoxicity after therapy. The cardiotoxic group tended to show more diffuse LV uptake, higher SUV, and ΔSUV of RV wall than the non-cardiotoxic group following therapy with anthracyclines or trastuzumab. Logistic regression analysis showed that the presence of RV wall uptake, SUV of RV wall (> 1.8), and ΔSUV of RV wall (> 0.4) were significantly associated with cardiotoxicity after controlling for age, radiotherapy, and treatment.

Conclusions

The presence of RV wall uptake and the increase of SUV of RV wall on post-therapy PET/CT were associated with cardiotoxicity in breast cancer patients who underwent anthracycline or trastuzumab. Oncologic FDG PET/CT scans can provide information regarding cancer therapy-induced cardiotoxicity as well as tumor response.

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Abbreviations

PET:

Positron emission tomography

CT:

Computed tomography

LV:

Left ventricular

RV:

Right ventricular

SUV:

Standardized uptake value

LVEF:

Left ventricular ejection fraction

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Acknowledgment

This study was supported by a grant (CRI17017-1) from Chonnam National University Hospital Biomedical Research Institute. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Disclosure

JK’s work has been funded by a grant (CRI17017-1) from Chonnam National University Hospital Biomedical Research Institute. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. All other authors declared no potential conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

This retrospective study was approved by the institutional ethics committee, and the requirement to obtain informed consent was waived.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Chonnam National University Hospital, Gwangju, South Korea

    Jahae Kim MD, PhD, Sang-Geon Cho MD, PhD & Ho-Chun Song MD, PhD

  2. Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, Hwasun, South Korea

    Sae-Ryung Kang MD, Su Woong Yoo MD, PhD, Seong Young Kwon MD, PhD, Jung-Joon Min MD, PhD & Hee-Seung Bom MD, PhD

  3. Department of Nuclear Medicine, Chonnam National University Hospital and Medical School, Jebongro 42, Donggu, Gwangju, 61469, Republic of Korea

    Ho-Chun Song MD, PhD

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  1. Jahae Kim MD, PhD
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  4. Su Woong Yoo MD, PhD
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  8. Ho-Chun Song MD, PhD
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Correspondence to Ho-Chun Song MD, PhD.

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Kim, J., Cho, SG., Kang, SR. et al. Association between FDG uptake in the right ventricular myocardium and cancer therapy-induced cardiotoxicity. J. Nucl. Cardiol. 27, 2154–2163 (2020). https://doi.org/10.1007/s12350-019-01617-y

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