Clinical Investigation
Value of 18F-FDG PET/CT in the detection of the anthracycline induced cardiotoxicity in non-Hodgkin lymphoma
Zhou Mingge, Qiu Chun, Wang Jianfeng, Shao Xiaoliang, Wang Yuetao
Published 2020-10-25
Cite as Chin J Nucl Med Mol Imaging, 2020, 40(10): 583-588. DOI: 10.3760/cma.j.cn321828-20190926-00212
Abstract
ObjectiveTo evaluate the value of standardized uptake value of the left ventricle (SUVLV) during 18F-fluorodeoxyglucose (FDG) PET/CT imaging in the detection of the cardiotoxicity of anthracycline in non-Hodgkin lymphoma (NHL).
MethodsTwenty-two patients(13 males and 9 females, age: ( 58±13 ) years) diagnosed as NHL from January 2016 to June 2019 were retrospectively enrolled in the study. All patients received chemotherapy regimens containing anthracycline. The gated myocardial perfusion imaging (GMPI) and whole body 18F-FDG PET/CT imaging were performed before and after chemotherapy in Changzhou First People′s Hospital. The significant reduction of diastolic function after chemotherapy measured by GMPI was defined as anthracycline induced myocardial injury. The SUVLV before and after chemotherapy and the changes (ΔSUVLV ) in patients with or without myocardial injury were compared with independent-sample t test or paired t test. The receiver operating characteristic (ROC) curve analysis was used to determine whether SUVLV could be used to detect anthracycline induced myocardial injury.
ResultsThe reduction of LVEF after chemotherapy was more significant in myocardial injury group (n=6) than that in patients without myocardial injury (n=16; ΔLVEF: (-5.8±7.5)% vs (2.7±3.8)%, t=2.657, P<0.05). After chemotherapy, an increase was found in SUVLV of patients with myocardial injury (maximum SUVLV (SUVLVmax): 7.5±4.4 vs 2.6±1.0, t=2.585, P<0.05; mean SUVLV (SUVLVmean): 3.7±2.2 vs 1.6±0.8, t=2.119, P>0.05), but no differences were found in SUVLV of patients without myocardial injury (SUVLVmax: 5.7±4.9 vs 5.6±4.8, SUVLVmean : 2.8±2.3 vs 2.8±2.2; t values: 0.130, 0.069, both P>0.05). Compared with patients without myocardial injury, patients with myocardial injury had higher ΔSUVLV (t values: 2.494, 2.163, both P<0.05) and lower pre-chemotherapy SUVLVmax (t=2.436, P<0.05). ROC curve analysis showed that ΔSUVLVmax and ΔSUV LVmean could be used for the detection of chemotherapy induced cardiotoxicity, and higher area under curve (AUC) of ΔSUV LVmaxwas found (AUC=0.844, 95% CI: 0.673-1.000). When the threshold value was 1.1, the sensitivity and specificity of ΔSUV LVmax in the detection of myocardial injury were 5/6 and 13/16, respectively.
ConclusionsHigher ΔSUV LVmax and ΔSUV LVmean, as well as lower baseline SUVLVmax are correlated with cardiotoxicity of anthracycline. ΔSUV LVmax has a potential for the diagnosis of anthracycline induced cardiotoxicity in patients with NHL.
Key words:
Lymphoma, non-Hodgkin; Cardiotoxicity; Drug therapy; Positron-emission tomography; Tomography, X-ray computed; Deoxyglucose
Contributor Information
Zhou Mingge
Department of Nuclear Medicine, the Third Affiliated Hospital of Soochow University, Changzhou First People′s Hospital, Changzhou 213003, China
Qiu Chun
Department of Nuclear Medicine, the Third Affiliated Hospital of Soochow University, Changzhou First People′s Hospital, Changzhou 213003, China
Wang Jianfeng
Department of Nuclear Medicine, the Third Affiliated Hospital of Soochow University, Changzhou First People′s Hospital, Changzhou 213003, China
Shao Xiaoliang
Department of Nuclear Medicine, the Third Affiliated Hospital of Soochow University, Changzhou First People′s Hospital, Changzhou 213003, China
Wang Yuetao
Department of Nuclear Medicine, the Third Affiliated Hospital of Soochow University, Changzhou First People′s Hospital, Changzhou 213003, China
