Key result
Myocardial metabolic activity measured by [18F]FDG PET/CT showed an overall increase during interim anthracycline treatment compared to staging, which then decreased at the end of treatment.
Why the study?
A multimodal approach is preferred for early detection of anthracycline-induced cardiotoxicity, prompting the development of an image processing tool to evaluate myocardial metabolic activity on routine [18F]FDG PET/CT images.
Does an image processing tool for [18F]FDG PET/CT detect early myocardial metabolic changes in lymphoma patients treated with anthracyclines?
Observational (n=24)
No
Does an image processing tool for [18F]FDG PET/CT detect early myocardial metabolic changes in lymphoma patients treated with anthracyclines?
A novel image processing tool for [18F]FDG PET/CT can quantify myocardial metabolic changes during anthracycline chemotherapy, showing transient increases in uptake, though larger prospective studies are needed to confirm its predictive value for cardiotoxicity.
Answers are grounded in this paper and cite their sources.
New FDG PET tool may enable early cardiotoxicity detection; leaves open prospective validation versus echocardiography before clinical use.
Purpose Chemotherapy-induced cardiotoxicity is one of the main complications during and after cancer treatment. While echocardiography is the most used technique in clinical practice to evaluate left ventricular (LV) dysfunction, a multimodal approach is preferred for the early detection of anthracycline-induced cardiotoxicity. In this paper, an image processing tool allowing the qualitative and quantitative analysis of myocardial metabolic activity by [18F]fluorodeoxyglucose (FDG) positron emission tomography computed tomography (PET/CT) images, acquired routinely during and after cancer treatment, is presented. Methods The methodology is based on cardiac single photon emission computed tomography image processing protocols used in clinical practice. LV polar maps are created, and quantitative regional values are calculated. The tool was validated in a study group of 24 patients with Hodgkin or non-Hodgkin lymphoma (HL and NHL, respectively) treated with anthracyclines. Staging, interim and end-of-treatment [18F]FDG PET/CT images were acquired and the presented tool was used to extract the quantitative metrics of LV metabolic activity. Results Results show an overall increase of metabolic activity in the interim PET image acquired while on treatment compared to staging PET, which then decreased in the end-of-treatment scan. Positive correlation coefficients between staging and interim scans, and negative correlation coefficients between interim and end-of-treatment scans also support this finding. Metabolic changes occur predominantly in the septal region. Conclusion The proposed methodology and presented software solution provides the capability to assess quantitatively myocardial metabolism acquired by routine [18F]FDG PET/CT scanning during cancer treatment for evaluating anthracycline-induced cardiotoxicity. The [18F]FDG PET/CT septal-lateral uptake ratio is proposed as a new quantitative measure of myocardial metabolism.
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Seiffert et al. (2021) conducted an observational in Hodgkin or non-Hodgkin lymphoma (n=24). Anthracycline chemotherapy vs. Baseline (staging scan) was evaluated on Quantitative metrics of left ventricular metabolic activity (SUVmean, SUVmax, septal-lateral uptake ratio). Myocardial metabolic activity measured by [18F]FDG PET/CT showed an overall increase during interim anthracycline treatment compared to staging, which then decreased at the end of treatment.
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