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Relationship of promising methods in the detection of anthracycline-induced cardiotoxicity in breast cancer patients.

Bulten BF, Verberne HJ, Bellersen L, Oyen WJ, Sabaté-Llobera A, Mavinkurve-Groothuis AM, Kapusta L, van Laarhoven HW, de Geus-Oei LF - Cancer Chemother. Pharmacol. (2015)

Bottom Line: The delayed planar H/M ratio is the most robust (123)I-mIBG parameter.It correlates with several conventional echocardiographic parameters, GLS, GRS and galectin-3.Of these, only GRS predicts the H/M ratio.

View Article: PubMed Central - PubMed

Affiliation: MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Zuidhorst Room 2.65, Drienerlolaan 5, PO Box 217, 7500 AE, Enschede, The Netherlands. benbulten@gmail.com.

ABSTRACT

Purpose: It remains challenging to identify patients at risk of anthracycline-induced cardiotoxicity. To better understand the different risk-stratifying approaches, we evaluated (123)I-metaiodobenzylguanidine ((123)I-mIBG) scintigraphy and its interrelationship with conventional echocardiography, 2D strain imaging and several biomarkers.

Methods: We performed (123)I-mIBG scintigraphy, conventional and strain echocardiography and biomarker (NT-proBNP, TNF-α, galectin-3, IL-6, troponin I, ST-2 and sFlt-1) assessment in 59 breast cancer survivors 1 year after anthracycline treatment. Interobserver and intermethod variability was calculated on planar and SPECT (123)I-mIBG scintigraphy, using the heart/mediastinum (H/M) ratio and washout (WO). Pearson's r and multivariate analyses were performed to identify correlations and independent predictors of (123)I-mIBG scintigraphy results.

Results: Delayed planar anterior whole-heart ROI (WH) H/M ratios and WO were the most robust (123)I-mIBG parameters. Significant correlations were observed between (123)I-mIBG parameters and several conventional echo parameters, global longitudinal and radial strain (GLS and GRS) and galectin-3. The highest Pearson's r was observed between delayed H/M ratio and GRS (Pearson's r 0.36, p = 0.01). Multivariate analysis showed that GRS was the only independent predictor of the delayed WH H/M ratio (p = 0.023).

Conclusion: The delayed planar H/M ratio is the most robust (123)I-mIBG parameter. It correlates with several conventional echocardiographic parameters, GLS, GRS and galectin-3. Of these, only GRS predicts the H/M ratio.

No MeSH data available.


Related in: MedlinePlus

Standardized approach for the placement of the mediastinal and heart ROIs for H/M ratio determination, adapted from Somsen and Flotats [16, 30] Notice the upper and lower boundary defining the upper mediastinum and the mediastinal midline. The heart ROI consists of either a circular ROI including the left ventricle and the cavum (whole-heart ROI—WH) or a small circular ROI on the left ventricle lateral wall (small LV ROI; Sm)
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Fig1: Standardized approach for the placement of the mediastinal and heart ROIs for H/M ratio determination, adapted from Somsen and Flotats [16, 30] Notice the upper and lower boundary defining the upper mediastinum and the mediastinal midline. The heart ROI consists of either a circular ROI including the left ventricle and the cavum (whole-heart ROI—WH) or a small circular ROI on the left ventricle lateral wall (small LV ROI; Sm)

Mentions: On the anterior planar images, 10–20 pixel regions of interest (ROI) were drawn over the upper mediastinum by two observers (BB and ASL) (Fig. 1) [16, 30]. This ROI was then placed over the LV anterior wall to obtain the small left ventricular (Sm) ROI. Furthermore, a whole-heart (WH) ROI was manually determined. Both ROIs were mirrored on the posterior planar images. For all planar images, H/M ratios were calculated by dividing the cardiac average counts per pixel by the mediastinal average counts per pixel. Furthermore, a geometric mean of the heart and mediastinum counts was calculated (by means of the formula ), resulting in the geo H/M ratio. Eventually, this resulted in two measurements of the H/M ratios (i.e. anterior and geometric mean) on two time points (i.e. early and delayed) and with two ROI methods (i.e. WH and Sm).Fig. 1


Relationship of promising methods in the detection of anthracycline-induced cardiotoxicity in breast cancer patients.

Bulten BF, Verberne HJ, Bellersen L, Oyen WJ, Sabaté-Llobera A, Mavinkurve-Groothuis AM, Kapusta L, van Laarhoven HW, de Geus-Oei LF - Cancer Chemother. Pharmacol. (2015)

Standardized approach for the placement of the mediastinal and heart ROIs for H/M ratio determination, adapted from Somsen and Flotats [16, 30] Notice the upper and lower boundary defining the upper mediastinum and the mediastinal midline. The heart ROI consists of either a circular ROI including the left ventricle and the cavum (whole-heart ROI—WH) or a small circular ROI on the left ventricle lateral wall (small LV ROI; Sm)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4612328&req=5

Fig1: Standardized approach for the placement of the mediastinal and heart ROIs for H/M ratio determination, adapted from Somsen and Flotats [16, 30] Notice the upper and lower boundary defining the upper mediastinum and the mediastinal midline. The heart ROI consists of either a circular ROI including the left ventricle and the cavum (whole-heart ROI—WH) or a small circular ROI on the left ventricle lateral wall (small LV ROI; Sm)
Mentions: On the anterior planar images, 10–20 pixel regions of interest (ROI) were drawn over the upper mediastinum by two observers (BB and ASL) (Fig. 1) [16, 30]. This ROI was then placed over the LV anterior wall to obtain the small left ventricular (Sm) ROI. Furthermore, a whole-heart (WH) ROI was manually determined. Both ROIs were mirrored on the posterior planar images. For all planar images, H/M ratios were calculated by dividing the cardiac average counts per pixel by the mediastinal average counts per pixel. Furthermore, a geometric mean of the heart and mediastinum counts was calculated (by means of the formula ), resulting in the geo H/M ratio. Eventually, this resulted in two measurements of the H/M ratios (i.e. anterior and geometric mean) on two time points (i.e. early and delayed) and with two ROI methods (i.e. WH and Sm).Fig. 1

Bottom Line: The delayed planar H/M ratio is the most robust (123)I-mIBG parameter.It correlates with several conventional echocardiographic parameters, GLS, GRS and galectin-3.Of these, only GRS predicts the H/M ratio.

View Article: PubMed Central - PubMed

Affiliation: MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Zuidhorst Room 2.65, Drienerlolaan 5, PO Box 217, 7500 AE, Enschede, The Netherlands. benbulten@gmail.com.

ABSTRACT

Purpose: It remains challenging to identify patients at risk of anthracycline-induced cardiotoxicity. To better understand the different risk-stratifying approaches, we evaluated (123)I-metaiodobenzylguanidine ((123)I-mIBG) scintigraphy and its interrelationship with conventional echocardiography, 2D strain imaging and several biomarkers.

Methods: We performed (123)I-mIBG scintigraphy, conventional and strain echocardiography and biomarker (NT-proBNP, TNF-α, galectin-3, IL-6, troponin I, ST-2 and sFlt-1) assessment in 59 breast cancer survivors 1 year after anthracycline treatment. Interobserver and intermethod variability was calculated on planar and SPECT (123)I-mIBG scintigraphy, using the heart/mediastinum (H/M) ratio and washout (WO). Pearson's r and multivariate analyses were performed to identify correlations and independent predictors of (123)I-mIBG scintigraphy results.

Results: Delayed planar anterior whole-heart ROI (WH) H/M ratios and WO were the most robust (123)I-mIBG parameters. Significant correlations were observed between (123)I-mIBG parameters and several conventional echo parameters, global longitudinal and radial strain (GLS and GRS) and galectin-3. The highest Pearson's r was observed between delayed H/M ratio and GRS (Pearson's r 0.36, p = 0.01). Multivariate analysis showed that GRS was the only independent predictor of the delayed WH H/M ratio (p = 0.023).

Conclusion: The delayed planar H/M ratio is the most robust (123)I-mIBG parameter. It correlates with several conventional echocardiographic parameters, GLS, GRS and galectin-3. Of these, only GRS predicts the H/M ratio.

No MeSH data available.


Related in: MedlinePlus