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Research ArticleImaging

PET/MRI Assessment of Acute Cardiac Inflammation 1 Month After Left-Sided Breast Cancer Radiation Therapy

Oi Wai Chau, Ali Islam, Michael Lock, Edward Yu, Robert Dinniwell, Brian Yaremko, Muriel Brackstone, William Pavlosky, John Butler, Heather Biernaski, Chantelle Graf, Gerald Wisenberg, Frank S. Prato and Stewart Gaede
Journal of Nuclear Medicine Technology May 2023, 264960; DOI: https://doi.org/10.2967/jnmt.122.264960
Oi Wai Chau
1London Regional Cancer Program, London, Ontario, Canada;
2Western University, London, Ontario, Canada;
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Ali Islam
2Western University, London, Ontario, Canada;
3Lawson Health Research Institute, London, Ontario, Canada; and
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Michael Lock
1London Regional Cancer Program, London, Ontario, Canada;
2Western University, London, Ontario, Canada;
4London Health Sciences Centre, London, Ontario, Canada
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Edward Yu
1London Regional Cancer Program, London, Ontario, Canada;
2Western University, London, Ontario, Canada;
4London Health Sciences Centre, London, Ontario, Canada
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Robert Dinniwell
1London Regional Cancer Program, London, Ontario, Canada;
2Western University, London, Ontario, Canada;
4London Health Sciences Centre, London, Ontario, Canada
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Brian Yaremko
1London Regional Cancer Program, London, Ontario, Canada;
2Western University, London, Ontario, Canada;
4London Health Sciences Centre, London, Ontario, Canada
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Muriel Brackstone
2Western University, London, Ontario, Canada;
3Lawson Health Research Institute, London, Ontario, Canada; and
4London Health Sciences Centre, London, Ontario, Canada
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William Pavlosky
3Lawson Health Research Institute, London, Ontario, Canada; and
4London Health Sciences Centre, London, Ontario, Canada
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John Butler
3Lawson Health Research Institute, London, Ontario, Canada; and
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Heather Biernaski
3Lawson Health Research Institute, London, Ontario, Canada; and
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Chantelle Graf
3Lawson Health Research Institute, London, Ontario, Canada; and
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Gerald Wisenberg
2Western University, London, Ontario, Canada;
3Lawson Health Research Institute, London, Ontario, Canada; and
4London Health Sciences Centre, London, Ontario, Canada
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Frank S. Prato
2Western University, London, Ontario, Canada;
3Lawson Health Research Institute, London, Ontario, Canada; and
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Stewart Gaede
1London Regional Cancer Program, London, Ontario, Canada;
3Lawson Health Research Institute, London, Ontario, Canada; and
4London Health Sciences Centre, London, Ontario, Canada
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Abstract

Our purpose was to investigate the utility of 18F-FDG PET/MRI and serial blood work to detect early inflammatory responses and cardiac functionality changes at 1 mo after radiation therapy (RT) in patients with left-sided breast cancer. Methods: Fifteen left-sided breast cancer patients who enrolled in the RICT-BREAST study underwent cardiac PET/MRI at baseline and 1 mo after standard RT. Eleven patients received deep-inspiration breath-hold RT, whereas the others received free-breathing RT. A list-mode 18F-FDG PET scan with glucose suppression was acquired. Myocardial inflammation was quantified by the change in 18F-FDG SUVmean (based on body weight) and analyzed on the basis of the myocardial tissue associated with the left anterior descending, left circumflex, or right coronary artery territories. MRI assessments, including left ventricular functional and extracellular volumes (ECVs), were extracted from T1 (before and during a constant infusion of gadolinium) and cine images, respectively, acquired simultaneously during the PET acquisition. Cardiac injury and inflammation biomarker measurements of high-sensitivity troponin T, high-sensitivity C-reactive protein, and erythrocyte sedimentation rate were measured at the 1-mo follow-up and compared with preirradiation values. Results: At the 1-mo follow-up, a significant increase (10%) in myocardial SUVmean in left anterior descending segments (P = 0.04) and ECVs in slices at the apex (6%) and base (5%) was detected (P ≤ 0.02). Further, a significant reduction in left ventricular stroke volume (−7%) was seen (P < 0.02). No significant changes in any circulating biomarkers were seen at follow-up. Conclusion: Myocardial 18F-FDG uptake and functional MRI, including stroke volume and ECVs, were sensitive to changes at 1 mo after breast cancer RT, with findings suggesting an acute cardiac inflammatory response to RT.

  • cardiac
  • inflammation
  • PET
  • MR
  • breast cancer
  • radiotherapy

Footnotes

  • Published online May 16, 2023.

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Journal of Nuclear Medicine Technology: 51 (2)
Journal of Nuclear Medicine Technology
Vol. 51, Issue 2
June 1, 2023
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PET/MRI Assessment of Acute Cardiac Inflammation 1 Month After Left-Sided Breast Cancer Radiation Therapy
Oi Wai Chau, Ali Islam, Michael Lock, Edward Yu, Robert Dinniwell, Brian Yaremko, Muriel Brackstone, William Pavlosky, John Butler, Heather Biernaski, Chantelle Graf, Gerald Wisenberg, Frank S. Prato, Stewart Gaede
Journal of Nuclear Medicine Technology May 2023, 264960; DOI: 10.2967/jnmt.122.264960

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PET/MRI Assessment of Acute Cardiac Inflammation 1 Month After Left-Sided Breast Cancer Radiation Therapy
Oi Wai Chau, Ali Islam, Michael Lock, Edward Yu, Robert Dinniwell, Brian Yaremko, Muriel Brackstone, William Pavlosky, John Butler, Heather Biernaski, Chantelle Graf, Gerald Wisenberg, Frank S. Prato, Stewart Gaede
Journal of Nuclear Medicine Technology May 2023, 264960; DOI: 10.2967/jnmt.122.264960
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Keywords

  • cardiac
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  • PET
  • MR
  • breast cancer
  • radiotherapy
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