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No changes in myocardial perfusion following radiation therapy of left-sided breast cancer: A positron emission tomography study

  • Original Article
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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

Adjuvant radiation therapy (RT) for breast cancer has improved overall survival. However, incidental exposure of the heart has been linked to development of radiation-induced heart disease. The aim of this study was, in a cohort of asymptomatic post-irradiation breast cancer patients, to investigate changes in myocardial blood flow (MBF) and presence of perfusion defects in myocardial perfusion positron-emission-tomography (PET) in the irradiated myocardium.

Methods and Results

Twenty patients treated with RT for left-sided breast cancer underwent 13N-ammonia myocardial perfusion PET 7(± 2) years after breath adapted RT to a total dose of 48 Gy given in 24 fractions. No differences in rest or stress MBF were noted between the irradiated and non-irradiated myocardium (1.29 (± 0.29) vs 1.33 (± 0.29) mL/g/min, ns; 2.74 (± 0.59) vs 2.78 (± 0.66) mL/g/min, ns, respectively). One patient demonstrated a myocardial perfusion defect localized in the irradiated anterior wall myocardium.

Conclusion

Although limited by a small sample size, early signs of cardiac injury detected by NH3 myocardial perfusion PET was at least not frequent in our cohort of patients treated with a modern RT technique for left-sided breast cancer, even 7 years after treatment. The findings however, may not rule out subsequent development of myocardial injury.

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Abbreviations

CACS:

Coronary Artery Calcium Score

CT:

Computed tomography

CVD:

Cardiovascular disease

LAD:

Left anterior descending artery

MBF:

Myocardial blood flow

MFR:

Myocardial flow reserve

NH3 :

Ammonia

PET:

Positron-emission-tomography

RCA:

Right coronary artery

RT:

Radiation therapy

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Disclosures

ANP has nothing to disclose. LS has the following disclosures: Member of advisory board and principal investigator, Takeda; Member of advisory board, Merck; Research agreement, Varian Medical Systems and Merck Serono; Principal investigator, Nanovi. MCA has the following disclosures Research agreement, Varian Medical Systems. PH has nothing to disclose. All other authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark

    Thomas Rasmussen MD, PhD, Andreas Kjær MD, PhD, DMSc, Martin Lyngby Lassen MSc, PhD & Philip Hasbak MD, DMSc

  2. Department of Oncology, Rigshospitalet University of Copenhagen, Copenhagen, Denmark

    Anders Navrsted Pedersen MD, PhD, Lena Specht MD, DMSc & Marianne C. Aznar MSc, PhD

Authors
  1. Thomas Rasmussen MD, PhD
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  2. Andreas Kjær MD, PhD, DMSc
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  6. Marianne C. Aznar MSc, PhD
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  7. Philip Hasbak MD, DMSc
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Correspondence to Thomas Rasmussen MD, PhD.

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Rasmussen, T., Kjær, A., Lassen, M.L. et al. No changes in myocardial perfusion following radiation therapy of left-sided breast cancer: A positron emission tomography study. J. Nucl. Cardiol. 28, 1923–1932 (2021). https://doi.org/10.1007/s12350-019-01949-9

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  • DOI: https://doi.org/10.1007/s12350-019-01949-9

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