Srinesh Alle MD, Presenter: Nothing to Disclose

O. Nachar MD, Abstract Co-Author: Nothing to Disclose

The purpose of this study was to determine a relation between myocardial FDG metabolism with FDG PET-CT scanning and the use of anthracycline chemotherapeutic agents which have been described extensively in the literature as being cardiotoxic. Increased FDG metabolism by the myocardium has been shown to be a response to myocardial insult such as ischemia and inflammation.

A retrospective study was conducted to review 24 consecutive patients who were newly diagnosed with lymphoma and underwent FDG PET-CT scanning before and after receiving cardiotoxic chemotherapy. Myocardial FDG metabolism was measured in the initial PET scan (baseline, pre-chemotherapy) and after chemotherapy treatment. The difference in myocardial FDG metabolism was calculated in each patient and was correlated with cardiac function tests, if available.

Twenty-one (88%) of the 24 patients demonstrated a significant increase of myocardial FDG metabolism in the post chemotherapy scans compared to the pre-chemotherapy scan. The overwhelming majority of these patients (86%), had greater than 100% increase in FDG metabolism in the myocardium. Three (12%) of the 24 patients demonstrated no significant change in myocardial FDG metabolism in the post chemotherapy scan. Unfortunately, not enough cardiac function tests were available in these patients to determine whether increased uptake of FDG corresponded to a decline in cardiac function.

The earliest manifestation of anthracycline cardiotoxicity may be at the molecular level, as evidenced by the altered myocardial metabolism of FDG before and after chemotherapy. Further research is needed to determine if this altered metabolism leads to decline in cardiac function.

The earliest manifestation of anthracycline cardiotoxicity may be at the molecular level, as evidenced by the altered myocardial metabolism of FDG before and after chemotherapy.

Alle, S, Nachar, O, FDG PET Myocardial Evaluation Pre- and Post-cardiotoxic Chemotherapy.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5004719.html