A pilot study of (13)N-ammonia cardiac PET imaging to assess subacute cardiotoxicity following adjuvant intensity-modulated radiotherapy for locally advanced breast cancer.
A pilot study of (13)N-ammonia cardiac PET imaging to assess subacute cardiotoxicity following adjuvant intensity-modulated radiotherapy for locally advanced breast cancer.
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DOI：
10.1016/j.clinimag.2020.07.026
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发表时间：
2020-12
期刊：
影响因子：
2.1
通讯作者：
Ho AY
中科院分区：
文献类型：
--
作者：
Nehmeh SA;Fox JJ;Schwartz J;Ballangrud ÅM;Schöder H;Zhao Y;Strauss HW;Yu A;Gupta D;Powell SN;Ho AY
(1)评估13 n -氨心脏PET （13 n -氨PET）成像在局部晚期乳腺癌（LABC）患者放疗（RT）治疗部位的可行性。(2)将放疗前后心肌血流储备（MFR）的变化与相应的心脏辐射剂量相关联。10例左侧LABC患者接受胸壁和区域淋巴结体积调节弧线治疗（VMAT），在基线和（中位）放疗后13个月进行休息/应激13 n -氨pet检查。基线和随访期间心功能和冠状动脉Ca2+评分的变化与心肌、3个冠状动脉区域和17个心肌节段的平均RT剂量相关。10名患者中有8名成功完成了研究。基线（随访）的平均休息（应激）整体MBF （ml.g . 1 min-1）分别为0.83±0.25（2.4±0.79）和0.92±0.30（2.76±0.71）。基线和随访期间MBF、心率、血压和心率压积（RPP）的差异不显著（P < 0.1）。MBF Rest与MBF Stress、RPP分别存在强相关（R = 0.79, P < 0.01）和中度相关（R = 0.53, P = 0.37）。在随访研究中，4例患者的MFR降低高达~41%，5/8的患者在高辐射等剂量线附近的心肌段MFR增加至~52%。6例患者基线和随访时Agatston Ca + 2评分均为零；2例患者在随访中Ca + 2轻度升高（范围：10-20）。在两项研究中，所有患者的休息和应激LVEF均正常（bbb50）。验证了13位n -氨pet显像在LABC患者治疗部位的可行性。50%的患者在心脏照射后1年的MFR下降。MFR可能是早期发现接受胸壁放射治疗的BC患者心脏毒性的潜在指标。
(1) Assess the feasibility of 13 N-ammonia cardiac PET (13 N-ammonia-PET) imaging in radiotherapy (RT) treatment position in locally-advanced breast cancer (LABC) patients. (2) Correlate pre – /post-RT changes in myocardial flow reserve (MFR) with the corresponding radiation heart dose. Ten left-sided LABC patients undergoing Volumetric Modulated-Arc-Therapy (VMAT) to chest wall and regional lymph nodes underwent a rest/stress 13 N-ammonia-PET at baseline and (median) 13 months post-RT. Changes in cardiac functions and coronary artery Ca2+ scoring between baseline and follow-up were correlated with average RT dose to the myocardium,3 coronary territories, and 17 myocardial segments. Eight (of 10) patients successfully completed the study. The average rest (stress) global MBF (ml.g-1.min-1) for baseline (follow-up) were 0.83 ± 0.25 (2.4 ± 0.79) and 0.92 ± 0.30 (2.76 ± 0.71), respectively. Differences in MBF, heart rate, blood pressure, and rate-pressure product (RPP) between baseline and follow-up were insignificant (P > 0.1).Strong (R = 0.79; P < 0.01) and moderate (R = 0.53; P = 0.37) correlation existed between MBF Rest and MBF Stress, and RPP respectively. Four patients showed a reduction in MFR of up to ~41% in follow-up studies, increasing to ~52% in myocardial segments close to high-radiation isodose lines in 5/8 patients. Agatston Ca + 2 scoring were zero in both baseline and follow-up in six patients; two patients exhibited mild increase in Ca + 2 on follow-ups (range:10–20).Rest and stress LVEF's were normal (> 50) for all patients in both studies. The feasibility of 13 N-ammonia-PET imaging in treatment position of LABC patients was demonstrated. MFR at 1-year post-irradiation of the heart decreased in 50% of the patients. MFR may be a potential index for early detection of cardiotoxicity in BC patients receiving RT to the chest wall.
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DOI：
10.1016/j.ijrobp.2010.04.072
发表时间：
2010-12-01
影响因子：
7
作者：
Jagsi, Reshma;Moran, Jean;Marsh, Robin;Masi, Kathryn;Griffith, Kent A.;Pierce, Lori J.
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DOI：
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发表时间：
2010-01-14
期刊：
BMJ (Clinical research ed.)
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影响因子：
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DOI：
10.1016/j.ijrobp.2005.01.029
发表时间：
2005-09-01
影响因子：
7
作者：
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