The utility of 18F-fluorodeoxyglucose positron emission tomography for early diagnosis of radiation-induced myocardial damage

Jingu, Keiichi; Kaneta, Tomohiro; Nemoto, Kenji; Ichinose, Azusa; Oikawa, Minako; Takai, Yoshihiro; Ogawa, Yoshihiro; Nakata, Eriko; Sakayauchi, Toru; Takai, Kenji; Sugawara, Toshiyuki; Narazaki, Kakutaro; Fukuda, Hiroshi; Takahashi, Satoshi; Yamada, Satoshi

doi:10.1016/j.ijrobp.2006.06.007

Cited by 77 publications

(61 citation statements)

References 18 publications

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“…A focal increase of FDG uptake was observed in the basal myocardium of up to 20% of patients with esophageal cancer after radiotherapy [16]. The areas of increased FDG uptake corresponded well to the irradiated field indicating possible radiation-induced myocardial damage.…”

Section: Discussionmentioning

confidence: 90%

Pitfalls in radiation oncology

et al. 2012

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Section: Discussionmentioning

confidence: 90%

Pitfalls in radiation oncology

et al. 2012

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“…Increased FDG uptake in normal tissues following irradiation has also been described for the lungs (23,28) and heart (29). Data from lung treatment suggests not only is there a dose response between radiation delivered to normal lung and subsequent FDG uptake (23), but the degree of FDG uptake in adjacent normal lung is also directly correlated with local control.…”

Section: Discussionmentioning

confidence: 92%

“…Data from lung treatment suggests not only is there a dose response between radiation delivered to normal lung and subsequent FDG uptake (23), but the degree of FDG uptake in adjacent normal lung is also directly correlated with local control. Jingu et al (29) have recently reported that increased FDG uptake in myocardium after radiotherapy may be correlated with myocardial injury. These authors reported that 13% of patients who received significant radiation dose to the heart had increased FDG uptake and retention several months after treatment.…”

Section: Discussionmentioning

confidence: 99%

Posttreatment FDG-PET Uptake in the Supraglottic and Glottic Larynx Correlates With Decreased Quality of Life After Chemoradiotherapy

Dornfeld

Hopkins

Simmons

et al. 2008

International Journal of Radiation Oncology*Biology*Physics

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Purpose-Inflammation and increased metabolic activity associated with oxidative stress in irradiated normal tissues may contribute to both complications following radiotherapy and increased glucose uptake as detected by post-therapy FDG PET imaging. We sought to determine if increased glucose uptake in normal tissues after chemoradiotherapy is associated with increased toxicity.Methods-Consecutive patients with locoregionally advanced head and neck cancers treated with IMRT and free of recurrence at one year were studied. FDG-PET imaging was obtained at 3 and 12 months post-treatment. SUV levels were determined at various head and neck regions. Functional outcome was measured using a quality of life questionnaire and weight loss and type of diet tolerated one year after therapy. A one-tailed Pearson correlation test was used to examine associations between SUV levels and functional outcome measures.Results-SUV levels in the supraglottic and glottic larynx from FDG PET imaging obtained 12 months post-treatment were inversely associated with quality of life measures and were correlated with a more restricted diet one year after therapy. SUV levels at 3 months after therapy did not correlate with functional outcome. Increases in SUV levels in normal tissues between 3 and 12 months were commonly found in the absence of recurrence.Conclusion-Altered metabolism in irradiated tissues persists one year after therapy. FDG PET scans may be used to assess normal tissue damage following chemoradiotherapy. These data support investigating hypermetabolic conditions associated with inflammation and\or oxidative stress as causal agents for radiation induced normal tissue damage.

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“…Focally increased 18 F-FDG uptake in the basal myocardium after radiotherapy has been hypothesized to be related to radiation-induced myocardial damage. Therefore, cardiac function and other symptoms should be followed carefully in patients with elevated 18 F-FDG uptake in the myocardium (143).…”

Section: Normal-tissue Response Evaluationmentioning

confidence: 99%

Molecular Imaging to Plan Radiotherapy and Evaluate Its Efficacy

2015

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Learning Objectives: On successful completion of this activity, participants should be able to describe (1) how to acquire high-quality molecular images for use in radiation therapy; (2) how molecular imaging can be used to plan radiotherapy and evaluate treatment efficacy; and (3) the limitations and challenges to widespread use of molecular imaging in radiation oncology.Financial Disclosure: The authors of this article have indicated no relevant relationships that could be perceived as a real or apparent conflict of interest. CME Credit: SNMMI is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNMMI designates each JNM continuing education article for a maximum of 2.0 AMA PRA Category 1 Credits. Physicians should claim only credit commensurate with the extent of their participation in the activity. For CE credit, SAM, and other credit types, participants can access this activity through the SNMMI website (http://www.snmmilearningcenter.org) through November 2018.Molecular imaging plays a central role in the management of radiation oncology patients. Specific uses of imaging, particularly to plan radiotherapy and assess its efficacy, require an additional level of reproducibility and image quality beyond what is required for diagnostic imaging. Specific requirements include proper patient preparation, adequate technologist training, careful imaging protocol design, reliable scanner technology, reproducible software algorithms, and reliable data analysis methods. As uncertainty in target definition is arguably the greatest challenge facing radiation oncology, the greatest impact that molecular imaging can have may be in the reduction of interobserver variability in target volume delineation and in providing greater conformity between target volume boundaries and true tumor boundaries. Several automatic and semiautomatic contouring methods based on molecular imaging are available but still need sufficient validation to be widely adopted. Biologically conformal radiotherapy (dose painting) based on molecular imaging-assessed tumor heterogeneity is being investigated, but many challenges remain to fully exploring its potential. Molecular imaging also plays increasingly important roles in both early (during treatment) and late (after treatment) response assessment as both a predictive and a prognostic tool. Because of potentially confounding effects of radiation-induced inflammation, treatment response assessment requires careful interpretation. Although molecular imaging is already strongly embedded in radiotherapy, the path to widespread and all-inclusive use is still long. The lack of solid clinical evidence is the main impediment to broader use. Recommendations for practicing physicians are still rather scarce. 18 F-FDG PET/CT remains the main molecular imaging modality in radiation oncology applications. Although other molecular imaging options (e.g., proliferation imaging) are becoming more common, their widespread use is limited ...

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The utility of 18F-fluorodeoxyglucose positron emission tomography for early diagnosis of radiation-induced myocardial damage

Cited by 77 publications

References 18 publications

Pitfalls in radiation oncology

Pitfalls in radiation oncology

Posttreatment FDG-PET Uptake in the Supraglottic and Glottic Larynx Correlates With Decreased Quality of Life After Chemoradiotherapy

Molecular Imaging to Plan Radiotherapy and Evaluate Its Efficacy

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