Assessment of myocardial extracellular volume on body computed tomography in breast cancer patients treated with anthracyclines
| Autor: | Alberto Luporini, Tommaso Bosetti, Elena De Benedictis, Caterina Beatrice Monti, Francesco Sardanelli, Marco Alì, Francesco Secchi, Moreno Zanardo |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Chemotherapy Cardiotoxicity Ejection fraction Anthracycline Imaging biomarker business.industry medicine.medical_treatment Incidence (epidemiology) 030204 cardiovascular system & hematology medicine.disease Radiation therapy 03 medical and health sciences 0302 clinical medicine Breast cancer 030220 oncology & carcinogenesis medicine Radiology Nuclear Medicine and imaging Original Article Radiology business |
| Zdroj: | Quant Imaging Med Surg |
| ISSN: | 2223-4292 |
| Popis: | BACKGROUND: Cancer treatment with anthracyclines may lead to an increased incidence of cardiac disease due to cardiotoxicity, as they may cause irreversible myocardial fibrosis. So far, the proposed methods for screening patients for cardiotoxicity have led to only limited success, while the analysis of myocardial extracellular volume (mECV) at cardiac magnetic resonance (CMR) has shown promising results, albeit requiring a dedicated exam. Recent studies have found strong correlations between mECV values obtained through computed tomography (CT), and those derived from CMR. Thus, our purpose was to evaluate the feasibility of estimating mECV on thoracic contrast-enhanced CT performed for staging or follow-up in breast cancer patients treated with anthracyclines, and, if feasible, to assess if a rise in mECV is associated with chemotherapy, and persistent over time. METHODS: After ethics committee approval, female patients with breast cancer who had undergone at least 2 staging or follow-up CT examinations at our institution, one before and one shortly after the end of chemotherapy including anthracyclines were retrospectively evaluated. Patients without available haematocrit, with artefacts in CT images, or who had undergone radiation therapy of the left breast were excluded. Follow-up CT examinations at longer time intervals were also analysed, when available. mECV was calculated on scans obtained at 1, and 7 min after contrast injection. RESULTS: Thirty-two female patients (aged 57±13 years) with pre-treatment haematocrit 38%±4%, and ejection fraction 64%±6% were analysed. Pre-treatment mECV was 27.0%±2.9% at 1 min, and 26.4%±3.8% at 7 min, similar to values reported for normal subjects in the literature. Post-treatment mECV (median interval: 89 days after treatment) was 31.1%±4.9%, and 30.0%±5.1%, respectively, values significantly higher than pre-treatment values at all times (P0.548) when compared to post-treatment values. CONCLUSIONS: mECV values from contrast-enhanced CT scans could play a role in the assessment of myocardial condition in breast cancer patients undergoing anthracycline-based chemotherapy. CT-derived ECV could be an imaging biomarker for the monitoring of therapy-related cardiotoxicity, allowing for potential secondary prevention of cardiac damage, using data derived from an examination that could be already part of patients’ clinical workflow. |
| Databáze: | OpenAIRE |
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