Evaluation of radiation-induced myocardial damage using iodine-123 β-methyl-iodophenyl pentadecanoic acid scintigraphy.

Evaluation of radiation-induced myocardial damage using iodine-123 β-methyl-iodophenyl pentadecanoic acid scintigraphy.
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DOI:
10.1093/jrr/rrt011
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发表时间:
2013-09
影响因子:
2
通讯作者:
Yamada S
Yamada S
中科院分区:
医学4区
文献类型:
--
作者:
Umezawa R;Takase K;Jingu K;Takanami K;Ota H;Kaneta T;Takeda K;Matsushita H;Ariga H;Takahashi S;Yamada S

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我们使用碘-123 β-甲基-碘苯基十五烷酸 (I-123 BMIPP) 闪烁扫描法评估了辐射引起的心肌损伤。 2010 年 5 月至 2011 年 4 月期间,我们对食管癌根治性放疗 (RT) 保持完全缓解超过六个月的患者进行了 I-123 BMIPP 闪烁扫描。我们使用基于轴向计算机断层扫描 (CT) 图像的 15 段模型,将 RT 野中的心肌面积与 I-123 BMIPP 摄取减少的心肌面积进行了比较。我们将片段分为三类:接收 40 Gy 的片段(Segment 40 Gy)、接收 60 Gy 的片段(Segment 60 Gy)和辐射场外的片段(Segment 0 Gy)。 RT 视野中摄取减少的片段被定义为阳性。总共 34 名患者的 510 个节段用于分析。从完成 RT 到 I-123 BMIPP 闪烁扫描的中位间隔为 22 个月(范围:6-103 个月)。 0 Gy 段、40 Gy 段和 60 Gy 段的数量分别为 324、133 和 53。 40 Gy 段的 42.9% (57/133)、60 Gy 段的 67.9% (36/53) 和 0 Gy 段的 13.3% (43/324) 检测到摄取减少。与放疗野外区域相比,40 Gy 和 60 Gy 的优势比分别为 5.2(95% 置信区间 [CI]:3.7-7.4)和 15.4(95% CI:6.9-34.6)。经常观察到放疗野中心肌 I-123 BMIPP 摄取减少,表明放疗引起的心肌损伤。 I-123 BMIPP 心肌闪烁扫描可能有助于识别放疗引起的心肌损伤。
We evaluated radiation-induced myocardial damage using iodine-123 β-methyl-iodophenyl pentadecanoic acid (I-123 BMIPP) scintigraphy. Between May 2010 and April 2011 we performed I-123 BMIPP scintigraphy for patients who had maintained complete response to curative radiotherapy (RT) for esophageal cancer for more than six months. We compared the area of the myocardium in the RT fields with that of reduced I-123 BMIPP uptake using a 15-segment model that is based on axial computed tomography (CT) images. We classified the segments into three categories: segments receiving 40 Gy (Segment 40 Gy), segments receiving 60 Gy (Segment 60 Gy) and segments out of the radiation fields (Segment 0 Gy). A segment with reduced uptake in the RT fields was defined as positive. A total of 510 segments in 34 patients were used for analysis. The median interval from completion of RT to I-123 BMIPP scintigraphy was 22 months (range, 6–103 months). The numbers of Segment 0 Gy, Segment 40 Gy and Segment 60 Gy were 324, 133 and 53, respectively. Reduced uptake was detected in 42.9% (57/133) of Segment 40 Gy, 67.9% (36/53) of Segment 60 Gy and 13.3% (43/324) of Segment 0 Gy. The odds ratios of 40 Gy and 60 Gy compared with regions out of the RT fields were 5.2 (95% confidence interval [CI]: 3.7–7.4) and 15.4 (95% CI: 6.9–34.6), respectively. Reduced myocardial I-123 BMIPP uptake in RT fields, suggesting RT-induced myocardial damage, was frequently observed. I-123 BMIPP myocardial scintigraphy may be useful for identifying RT-induced myocardial damage.
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