Novel Cardiac Computed Tomography Methods for the Assessment of Anthracycline Induced Cardiotoxicity

Figures

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  FIGURE 1. Novel cardiac computed tomography (CT) approaches for the assessment of anthracycline induced cardiotoxicity. CAD, coronary artery disease.

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  FIGURE 2. Contrast CineCT and 99mTc-Tetrofosmin SPECT imaging and masking in porcine heart: (a) in vivo contrast CineCT short- and long-axis imaging of porcine heart on day 7 after myocardial infarction (MI), (b) in vivo SPECT short- and long-axis imaging of the porcine heart on day 7 after MI, (c) SPECT-derived regional masks for strain fields of normal (white, > 60% max intensity), border (light gray, > 50% and < 60% max intensity), and infarct (dark gray, < 50% max intensity) regions, and (d) SPECT strain masks overlaid on radial strain field. Ex vivo contrast CineCT imaging of the arrested porcine heart 7 after hydrogel delivery: (e) custom aortic valve insert and suspension fixture, (f) MI region and perfusion of right coronary artery (RCA) and left circumflex coronary artery (LCx), and (g) MI region and left anterior descending coronary artery (LAD). Note: this image is reproduced with permission from Midgett et al. (33).

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  FIGURE 3. Computed tomography (CT) based assessment of coronary vasoreactivity in a canine model of doxorubicin (DOX) induced cardiotoxicity. Left ventricular ejection fraction (LVEF) was not reduced until a cumulative DOX dose of 12 to 15 mg/kg was administered, whereas impairment in ADE-induced vasodilator responses occurred early in the progression of DOX-induced cardiotoxicity similar to impairment in global longitudinal strain (GLS). 2D = 2-dimensional; TTE = transthoracic echocardiography. Note: this image is reproduced with permission from Feher et al. (28).

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  FIGURE 4. Cardiac computed tomography (CCT) and cardiac magnetic resonance (CMR) imaging in 7 patients who underwent anthracycline treatment. Arrows and arrowheads indicate late iodine and gadolinium enhancements, respectively. ECV, extracellular volume. Note: this image is reproduced with permission from Sueta et al. (74).

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  FIGURE 5. Examples of computed tomography extracellular volume (ECV) maps in control rabbits and rabbits undergoing anthracycline-based chemotherapy generated by dual energy CT acquisition. (A) Control subject (Hct = 44.4%), ECV = 27.0%; dark blue normal myocardium shown on the ECV map. (B) Six-week treatment model (Hct = 37.4%), ECV = 36.4%; dark blue septal wall changed to bright blue. (C) Twelve-week model (Hct = 30.0%), ECV = 44.0%; dark blue area of inferoseptal/inferolateral wall changed to bright blue myocardium. (D) Sixteen-week model (Hct = 25.0%), ECV = 46.0%; bright blue myocardium suggests myocardial fibrosis. Hct = hematocrit. Note: this image is reproduced with permission from Hong et al. (69).