A prospective comparison of cardiac magnetic resonance imaging and radionuclide ventriculography in the assessment of cardiac function in patients treated with anthracycline-based chemotherapy

作者：Petri Sipola^*; Esko Vanninen; Esa Jantunen; Tapio Nousiainen; Mikko Kiviniemi; Juha Hartikainen; Taru Kuittinen

来源：Nuclear Medicine Communications, 2012, 33(1): 51-59.

DOI：10.1097/MNM.0b013e32834bfec4

• anthracycline chemotherapy
• cardiac magnetic resonance imaging
• cardiotoxicity
• left ventricular ejection fraction
• non-Hodgkin lymphoma
• radionuclide ventriculography

Purpose To compare cardiac MRI and radionuclide ventriculography (RVG) in cardiac monitoring during anthracycline (doxorubicin)-based chemotherapy. %26lt;br%26gt;Materials and methods We studied 10 previously untreated adult non-Hodgkin lymphoma patients. Left ventricular ejection fraction (LVEF) was assessed by MRI and RVG simultaneously. In addition, left ventricular (LV) and left atrial size were determined by MRI. Both MRI and RVG measurements were determined at baseline and then repeated after eight cycles of CHOP chemotherapy (cumulative doxorubicin dose of 400mg/m(2)). Power calculations were made on the basis of reproducibility measurements. %26lt;br%26gt;Results Clinical heart failure was not observed in any patient during the study. MRI detected a statistically significant increase in LV end-diastolic volume (128 +/- 39 vs. 151 +/- 46ml, P%26lt;0.05) and LV mass (119 +/- 32 vs. 146 +/- 49 g, P%26lt;0.05) after doxorubicin therapy but no change in LVEF (46 +/- 8 vs. 47 +/- 11%, P=NS) or left atrial area. A significant LVEF reduction compared with baseline was observed by RVG (61 +/- 10 vs. 50 +/- 6%, P%26lt;0.01). On average, MRI resulted in 7 +/- 10% lower LVEF values compared with RVG. %26lt;br%26gt;Conclusion RVG seems to be a valuable and repeatable tool in detecting early, subclinical deterioration in cardiac function and is the method of choice in the follow-up of LV function during anthracycline-based chemotherapy. Whether LV volumetric and mass changes found in MRI could predict later significant permanent cardiac damage should be evaluated in larger studies with long-term follow-up.

• 出版日期2012-1