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08.10.2018 | Original Article

Rubidium-82 positron emission tomography for detection of acute doxorubicin-induced cardiac effects in lymphoma patients

Zeitschrift:
Journal of Nuclear Cardiology
Autoren:
MD Adam Høgsbro Laursen, MD Marie Bayer Elming, MD, DMSc Rasmus Sejersten Ripa, MD, DMSc Philip Hasbak, MD, DMSc Andreas Kjær, MD, DMSc Lars Køber, MSc Jacob Louis Marott, MD, PhD Jens Jakob Thune, MD, PhD Martin Hutchings
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s12350-018-1458-6) contains supplementary material, which is available to authorized users.
The authors of this article have provided a PowerPoint file, available for download at SpringerLink, which summarizes the contents of the paper and is free for re-use at meetings and presentations. Search for the article DOI on SpringerLink.com.

Abstract

Background

Doxorubicin is a cornerstone in lymphoma treatment, but is limited by dose-dependent cardiotoxicity. Rubidium-82 positron emission tomography (82Rb PET) assesses coronary microvascular function through absolute quantification of myocardial perfusion and myocardial perfusion reserve (MPR). Doxorubicin-induced microvascular injury represents a potential early marker of cardiotoxicity.

Methods and results

We included 70 lymphoma patients scheduled for doxorubicin-based treatment. Cardiotoxicity was evaluated with 82Rb PET myocardial perfusion imaging during rest and adenosine stress before chemotherapy and shortly after the first doxorubicin exposure. Patients with a MPR decline > 20% were defined as having a low threshold for cardiotoxicity. In the 54 patients with complete data sets, MPR was significantly lower after the initial doxorubicin exposure (2.69 vs 2.51, P = .03). We registered a non-significant decline in stress perfusion (3.18 vs 3.02 ml/g/min, P = .08), but no change in resting myocardial perfusion. There were 13 patients with a low cardiotoxic threshold. These patients had a significantly higher age, but were otherwise similar to the remaining part of the study population.

Conclusion

Decreases in MPR after initial doxorubicin exposure in lymphoma patients may represent an early marker of doxorubicin-induced cardiotoxicity. The prognostic value of acute doxorubicin-induced changes in MPR remains to be investigated.

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Zusatzmaterial
Supplementary material 1 (DOCX 18 kb)
12350_2018_1458_MOESM1_ESM.docx
Supplementary material 2 (PPTX 506 kb)
12350_2018_1458_MOESM2_ESM.pptx
Literatur
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