The utility of 18F-fluorodeoxyglucose positron emission tomography for early diagnosis of radiation-induced myocardial damage

Keiichi Jingu, Tomohiro Kaneta, Kenji Nemoto, Azusa Ichinose, Minako Oikawa, Yoshihiro Takai, Yoshihiro Ogawa, Eiko Nakata, Toru Sakayauchi, Kenji Takai, Toshiyuki Sugawara, Kakutaro Narazaki, Hiroshi Fukuda, Shoki Takahashi, Shogo Yamada

Research output: Contribution to journalArticlepeer-review

52 Citations (Scopus)

Abstract

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 123I-BMIPP uptake and four showed low 201TlCl 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.

Original languageEnglish
Pages (from-to)845-851
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Volume66
Issue number3
DOIs
Publication statusPublished - 2006 Nov 1

Keywords

  • Delayed contrast MRI
  • FDG-PET
  • Myocardial SPECT
  • Radiation-induced cardiomyopathy
  • Radiotherapy

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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