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18.11.2019 | Original Article

No changes in myocardial perfusion following radiation therapy of left-sided breast cancer: A positron emission tomography study

Journal of Nuclear Cardiology
MD, PhD Thomas Rasmussen, MD, PhD, DMSc Andreas Kjær, MSc, PhD Martin Lyngby Lassen, MD, PhD Anders Navrsted Pedersen, MD, DMSc Lena Specht, MSc, PhD Marianne C. Aznar, MD, DMSc Philip Hasbak
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The online version of this article (https://​doi.​org/​10.​1007/​s12350-019-01949-9) contains supplementary material, which is available to authorized users.
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Adjuvant radiation therapy (RT) for breast cancer has improved overall survival. However, incidental exposure of the heart has been linked to development of radiation-induced heart disease. The aim of this study was, in a cohort of asymptomatic post-irradiation breast cancer patients, to investigate changes in myocardial blood flow (MBF) and presence of perfusion defects in myocardial perfusion positron-emission-tomography (PET) in the irradiated myocardium.

Methods and Results

Twenty patients treated with RT for left-sided breast cancer underwent 13N-ammonia myocardial perfusion PET 7(± 2) years after breath adapted RT to a total dose of 48 Gy given in 24 fractions. No differences in rest or stress MBF were noted between the irradiated and non-irradiated myocardium (1.29 (± 0.29) vs 1.33 (± 0.29) mL/g/min, ns; 2.74 (± 0.59) vs 2.78 (± 0.66) mL/g/min, ns, respectively). One patient demonstrated a myocardial perfusion defect localized in the irradiated anterior wall myocardium.


Although limited by a small sample size, early signs of cardiac injury detected by NH3 myocardial perfusion PET was at least not frequent in our cohort of patients treated with a modern RT technique for left-sided breast cancer, even 7 years after treatment. The findings however, may not rule out subsequent development of myocardial injury.

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