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Changes on myocardial perfusion scintigraphy and contrast-enhanced cardiac magnetic resonance imaging after definitive radiotherapy in patients with lung cancer

Published online by Cambridge University Press:  10 March 2021

A. Lideståhl Open the ORCID record for A. Lideståhl [Opens in a new window] ,
T. Larsson ,
L. Thorén ,
O. Brodin  and
P. A. Lind
A. Lideståhl*
Affiliation:
Department of Oncology-Pathology, Karolinska Institutet
T. Larsson
Affiliation:
Department of Clinical Sciences, Divisions of Clinical Physiology and Nuclear Medicine, Karolinska Institutet, Danderyd Hospital
L. Thorén
Affiliation:
Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden
O. Brodin
Affiliation:
Department of Oncology-Pathology, Karolinska Institutet
P. A. Lind
Affiliation:
Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden
*
Author for correspondence: A. Lideståhl, Department of Oncology-Pathology, Karolinska Institutet, Karolinska vägen, A2:07, 171 64 Solna, Sweden; E-mail: anders.lidestahl@sll.se
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Abstract

Aim:

To determine whether myocardial perfusion scintigraphy (MPS) changes in lung cancer patients treated with radiotherapy (RT) were detectable with late gadolinium enhancement cardiac magnetic resonance imaging (LGE CMR).

Materials and methods:

Twenty-one patients with lung cancer were evaluated pre-RT and at 2 and 6 months post-RT follow-up (FU) with MPS and LGE CMR. MPS changes in the left ventricle (LV) were analysed using the semi-quantitative summed rest score method (20 segments) and the Bull’s-eye-view technique. The LGE CMR studies were analysed for visual signs of myocardial damage (fibrosis), that is, focal LGE in the LV and cardiac function parameters.

Results:

MPS changes were detected in 7/20 patients at 2 months FU and in 8/13 patients at 6 months FU. Only one patient had a new irreversible defect judged to be caused by direct irradiation. MPS changes in two cases were deemed to be caused by attenuation. All new MPS defects were minor and no corresponding myocardial damage, or any functional changes, were evident on LGE CMR.

Findings:

The extent of MPS changes at 6 months FU appeared less prominent than in previous reports. No visual signs or functional changes corresponding to myocardial damage were detected on LGE CMR. A risk for false-positive MPS changes caused by attenuation is evident.

Keywords

radiotherapylung cancermyocardial perfusion scintigraphymyocardial late gadolinium enhancement cardiac magnetic resonance imagingradiation-induced heart disease
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 21 , Issue 4 , December 2022 , pp. 455 - 461
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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