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Research ArticleCONTINUING EDUCATION

Scintigraphic Techniques for Early Detection of Cancer Treatment–Induced Cardiotoxicity

Lioe-Fee de Geus-Oei, Annelies M.C. Mavinkurve-Groothuis, Louise Bellersen, Martin Gotthardt, Wim J.G. Oyen, Livia Kapusta and Hanneke W.M. van Laarhoven
Journal of Nuclear Medicine Technology September 2013, 41 (3) 170-181; DOI: https://doi.org/10.2967/jnumed.110.082784
Lioe-Fee de Geus-Oei
1Department of Nuclear Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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Annelies M.C. Mavinkurve-Groothuis
2Department of Pediatric Hematology and Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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Louise Bellersen
3Department of Cardiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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Martin Gotthardt
1Department of Nuclear Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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Wim J.G. Oyen
1Department of Nuclear Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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Livia Kapusta
4Children's Heart Centre, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
5Heart Institute, Schneider Children's Medical Center of Israel, Petach Tikvah, Israel; and
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Hanneke W.M. van Laarhoven
6Department of Medical Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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    FIGURE 1.

    Calculation of heart-to-mediastinum count ratio of 123I-MIBG. Region of interest (ROI) is drawn around left ventricle and in mediastinum. Mediastinal position of ROI is standardized in relation to lung apex, lower boundary of upper mediastinum, and mediastinal midline. Same ROIs are applied for early 15-min postinjection and late 4-h postinjection images, to calculate 4-h washout rates.Embedded Imagewhere H is decay-corrected average counts of heart ROI, and M is decay-corrected average counts of mediastinum ROI.

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    TABLE 1

    Cardiovascular Adverse Effects of Several Anticancer Agents

    EffectAgent
    Myocardial depressionAnthracyclines, mitoxantrone, high-dose cyclophosphamide, trastuzumab, ifosfamide, all-trans retinoic acid
    Ischemia5-fluorouracil, cisplatin, capecitabine, interleukin-2
    HypotensionEtoposide, paclitaxel, alemtuzumab, cetuximab, rituximab, interleukin-2, denileukin, interferon-α, all-trans retinoic acid, homoharringtonine
    HypertensionBevacizumab, cisplatin
    OtherBusulfan (cardiac tamponade, endomyocardial fibrosis) Cyclophosphamide (hemorrhagic myocarditis)
    Paclitaxel, thalidomide (bradyarrhythmias) Arsenic trioxide (QT prolongation or torsades de pointes)
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    TABLE 2

    Single-Photon Techniques for Early Detection of Cardiotoxicity

    TechniqueTracer
    Mechanical (pump) function99mTc MUGA (radionuclide ventriculography or equilibrium radionuclide angiocardiography) 99mTc gated blood-pool SPECT
    Neuronal imaging123I-MIBG See Table 3 for neuronal imaging PET tracers
    Imaging necrosis/cell death111In-antimyosin
    Imaging cell death/apoptosis99mTc-annexin V
    Fatty acid use123I-BMIPP 123I-paraphenyl pentadecanoic acid
    Therapeutic target imaging111In-trastuzumab
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    TABLE 3

    Radiotracers for Sympathetic Neuronal PET

    TracerAction
    Presynaptic tracersVisualize inhibition of further neurotransmission
    True catecholaminesBehave identically to endogenous neurotransmitters
     18F-6-fluorodopamine
     11C-epinephrine
    Catecholamine analogsFalse neurotransmitters
     11C-meta-hydroxyephedrine (HED)
     11C-phenylephrine
     18F-6-fluorometaraminol
    Postsynaptic tracersVisualize transmission of sympathetic signal to target tissue
     11C-CGP12177
     11C-CGP12388
     11C-GB67
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Journal of Nuclear Medicine Technology: 41 (3)
Journal of Nuclear Medicine Technology
Vol. 41, Issue 3
September 1, 2013
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Scintigraphic Techniques for Early Detection of Cancer Treatment–Induced Cardiotoxicity
Lioe-Fee de Geus-Oei, Annelies M.C. Mavinkurve-Groothuis, Louise Bellersen, Martin Gotthardt, Wim J.G. Oyen, Livia Kapusta, Hanneke W.M. van Laarhoven
Journal of Nuclear Medicine Technology Sep 2013, 41 (3) 170-181; DOI: 10.2967/jnumed.110.082784

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Scintigraphic Techniques for Early Detection of Cancer Treatment–Induced Cardiotoxicity
Lioe-Fee de Geus-Oei, Annelies M.C. Mavinkurve-Groothuis, Louise Bellersen, Martin Gotthardt, Wim J.G. Oyen, Livia Kapusta, Hanneke W.M. van Laarhoven
Journal of Nuclear Medicine Technology Sep 2013, 41 (3) 170-181; DOI: 10.2967/jnumed.110.082784
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  • Article
    • Abstract
    • POTENTIAL MECHANISMS OF CARDIOTOXICITY
    • ROLE OF SURVEILLANCE AND EARLY DETECTION OF CARDIOTOXICITY
    • NONINVASIVE IMAGING OF CARDIOTOXICITY
    • 99MTC MUGA
    • 99MTC GATED BLOOD-POOL SPECT
    • 123I-LABELED MIBG SCINTIGRAPHY
    • CARDIAC SYMPATHETIC NEURONAL IMAGING USING PET
    • 111IN-ANTIMYOSIN AND 99MTC-LABELED ANNEXIN V
    • FATTY ACID USE
    • 111IN-TRASTUZUMAB
    • SUMMARY AND FUTURE PERSPECTIVES
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  • Illuminating the Hidden: Standardizing Cardiac MIBG Imaging for Sympathetic Dysfunction
  • PET/CT Case Series: Unmasking the Mystery of Cardiac Sarcoidosis
  • Delivery Methods of Radiopharmaceuticals: Exploring Global Strategies to Minimize Occupational Radiation Exposure
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Keywords

  • cardiotoxicity
  • cancer treatment
  • early detection
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