Myocardial 18 F-FDG Uptake Pattern for Cardiovascular Risk Stratification in Patients Undergoing Oncologic PET/CT.

Autor: Haider A; Department of Nuclear Medicine, University Hospital Zurich, 8091 Zurich, Switzerland.; Center for Molecular Cardiology, University of Zurich, 8952 Schlieren, Switzerland., Bengs S; Department of Nuclear Medicine, University Hospital Zurich, 8091 Zurich, Switzerland.; Center for Molecular Cardiology, University of Zurich, 8952 Schlieren, Switzerland., Schade K; Department of Nuclear Medicine, University Hospital Zurich, 8091 Zurich, Switzerland.; Center for Molecular Cardiology, University of Zurich, 8952 Schlieren, Switzerland., Wijnen WJ; Department of Nuclear Medicine, University Hospital Zurich, 8091 Zurich, Switzerland.; Center for Molecular Cardiology, University of Zurich, 8952 Schlieren, Switzerland., Portmann A; Department of Nuclear Medicine, University Hospital Zurich, 8091 Zurich, Switzerland.; Center for Molecular Cardiology, University of Zurich, 8952 Schlieren, Switzerland., Etter D; Department of Nuclear Medicine, University Hospital Zurich, 8091 Zurich, Switzerland.; Center for Molecular Cardiology, University of Zurich, 8952 Schlieren, Switzerland., Fröhlich S; Department of Nuclear Medicine, University Hospital Zurich, 8091 Zurich, Switzerland.; Center for Molecular Cardiology, University of Zurich, 8952 Schlieren, Switzerland., Warnock GI; Department of Nuclear Medicine, University Hospital Zurich, 8091 Zurich, Switzerland.; Center for Molecular Cardiology, University of Zurich, 8952 Schlieren, Switzerland., Treyer V; Department of Nuclear Medicine, University Hospital Zurich, 8091 Zurich, Switzerland., Burger IA; Department of Nuclear Medicine, University Hospital Zurich, 8091 Zurich, Switzerland., Fiechter M; Department of Nuclear Medicine, University Hospital Zurich, 8091 Zurich, Switzerland.; Center for Molecular Cardiology, University of Zurich, 8952 Schlieren, Switzerland.; Swiss Paraplegic Center, 6207 Nottwil, Switzerland., Kudura K; Department of Nuclear Medicine, University Hospital Zurich, 8091 Zurich, Switzerland., Fuchs TA; Department of Nuclear Medicine, University Hospital Zurich, 8091 Zurich, Switzerland., Pazhenkottil AP; Department of Nuclear Medicine, University Hospital Zurich, 8091 Zurich, Switzerland., Buechel RR; Department of Nuclear Medicine, University Hospital Zurich, 8091 Zurich, Switzerland., Kaufmann PA; Department of Nuclear Medicine, University Hospital Zurich, 8091 Zurich, Switzerland., Meisel A; Department of Nuclear Medicine, University Hospital Zurich, 8091 Zurich, Switzerland.; Center for Molecular Cardiology, University of Zurich, 8952 Schlieren, Switzerland., Stolzmann P; Department of Nuclear Medicine, University Hospital Zurich, 8091 Zurich, Switzerland., Gebhard C; Department of Nuclear Medicine, University Hospital Zurich, 8091 Zurich, Switzerland.; Center for Molecular Cardiology, University of Zurich, 8952 Schlieren, Switzerland.; Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, 1090 Vienna, Austria.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2020 Jul 17; Vol. 9 (7). Date of Electronic Publication: 2020 Jul 17.
DOI: 10.3390/jcm9072279
Abstrakt: Objective: Positron emission tomography/computed tomography with 18 F-fluorodeoxy-glucose ( 18 F-FDG-PET/CT) has become the standard staging modality in various tumor entities. Cancer patients frequently receive cardio-toxic therapies. However, routine cardiovascular assessment in oncologic patients is not performed in current clinical practice. Accordingly, this study sought to assess whether myocardial 18 F-FDG uptake patterns of patients undergoing oncologic PET/CT can be used for cardiovascular risk stratification.
Methods: Myocardial 18 F-FDG uptake pattern was assessed in 302 patients undergoing both oncologic whole-body 18 F-FDG-PET/CT and myocardial perfusion imaging by single-photon emission computed tomography (SPECT-MPI) within a six-month period. Primary outcomes were myocardial 18 F-FDG uptake pattern, impaired myocardial perfusion, ongoing ischemia, myocardial scar, and left ventricular ejection fraction.
Results: Among all patients, 109 (36.1%) displayed no myocardial 18 F-FDG uptake, 77 (25.5%) showed diffuse myocardial 18 F-FDG uptake, 24 (7.9%) showed focal 18 F-FDG uptake, and 92 (30.5%) had a focal on diffuse myocardial 18 F-FDG uptake pattern. In contrast to the other uptake patterns, focal myocardial 18 F-FDG uptake was predominantly observed in patients with myocardial abnormalities (i.e., abnormal perfusion, impaired LVEF, myocardial ischemia, or scar). Accordingly, a multivariate logistic regression identified focal myocardial 18 F-FDG uptake as a strong predictor of abnormal myocardial function/perfusion (odds ratio (OR) 5.32, 95% confidence interval (CI) 1.73-16.34, p = 0.003). Similarly, focal myocardial 18 F-FDG uptake was an independent predictor of ongoing ischemia and myocardial scar (OR 4.17, 95% CI 1.53-11.4, p = 0.005 and OR 3.78, 95% CI 1.47-9.69, p = 0.006, respectively).
Conclusions: Focal myocardial 18 F-FDG uptake seen on oncologic PET/CT indicates a significantly increased risk for multiple myocardial abnormalities. Obtaining and taking this information into account will help to stratify patients according to risk and will reduce unnecessary cardiovascular complications in cancer patients.
Databáze: MEDLINE
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