The utility of 18F-fluorodeoxyglucose positron emission tomography for early diagnosis of radiation-induced myocardial damage
The utility of 18F-fluorodeoxyglucose positron emission tomography for early diagnosis of radiation-induced myocardial damage
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DOI：
10.1016/j.ijrobp.2006.06.007
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发表时间：
2006-11-01
影响因子：
7
通讯作者：
Yamada, Shogo
中科院分区：
文献类型：
--
作者：
Jingu, Keiichi;Kaneta, Tomohiro;Yamada, Shogo
目的：应用氟代脱氧葡萄糖正电子发射断层扫描(FDG-PET)评价食道癌患者放疗后基础心肌局部摄取增加的临床意义。方法与材料：2004年8月至2005年7月，胸段食管癌放疗后3个月以上行FDG-PET检查。一些患者表现出心肌基底部FDG摄取增加。为了阐明这些发现的临床意义，进行了进一步的心脏检查。结果：13例(20.3%)患者照射野对应的基础心肌摄取FDG明显高于照射野以外的心肌摄取。13名患者中有8名同意接受心脏检查。在这8名患者中，5名患者显示低I-123-BMIPP摄取，4名患者显示心肌低摄取(TICI)-T-201，与高摄取FDG区域相对应。2例患者在Gd-DTPA磁共振成像(MRI)上发现部分高摄取FDG区域出现延迟强化，1例患者在电影MRI上表现为运动减退。结论：食管癌放疗后FDG-PET常表现为基底区心肌局部摄取增加。这一发现表明辐射导致心脏损害的可能性，这类患者的心脏功能和症状应密切关注。(C)2006年爱思唯尔公司。
Purpose: We evaluated the clinical significance of focal increased uptake in the basal myocardium on F-fluorodeoxyglucose positron emission tomography (FDG-PET) in patients with esophageal cancer after radiotherapy.Methods and Materials: Between August 2004 and July 2005, a total of 64 patients who had been irradiated for thoracic esophageal cancer underwent FDG-PET at least three months after the completion of chemoradiotherapy. Some patients showed increased FDG uptake in the basal portion of the myocardium. To clarify the clinical significance of these findings, further examinations of hearts were performed. The dose distribution in the myocardium with high FDG uptake was also analyzed retrospectively.Results: Thirteen (20.3%) of the 64 patients showed high FDG uptake in the basal myocardium corresponding to the irradiated fields compared with FDG uptake in the myocardium outside the irradiated fields. Eight of the 13 patients consented to undergo examinations of the heart. Five of those eight patients showed low I-123-BMIPP uptake and four showed low (TICI)-T-201 uptake in the myocardium corresponding with high FDG uptake regions. In two patients, delayed enhancement was found in some parts of the area with high FDG uptake on Gd-DTPA magnetic resonance imaging (MRI), and the delay-enhanced lesion showed hypokinesia on cine-MRI in one patient.Conclusions: FDG-PET often shows focal increased uptake in the basal myocardium after radiotherapy for esophageal cancer. This finding indicates the possibility of radiation-induced cardiac damage, and cardiac function and symptoms of such patients should be followed carefully. (c) 2006 Elsevier Inc.