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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

Bland–Altman plots of interobserver difference versus mean of planar anterior (a) and geometric (b) WH H/M ratio, both on early and on delayed images. Butted lines represent 95 % limits of agreement. A. Mean differences: early images −0.04 (95 % CI −0.10 to 0.01), R2 = 1.0 e−5; delayed images −0.01 (95 % CI −0.07 to 0.04), R2 = 0.01. B. Mean differences: early images 0.03 (95 % CI −0.01 to 0.08) R2 = 0.01; delayed images 0.06 (95 % CI 0.02–0.10), R2 = 2.2 e−4
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Fig2: Bland–Altman plots of interobserver difference versus mean of planar anterior (a) and geometric (b) WH H/M ratio, both on early and on delayed images. Butted lines represent 95 % limits of agreement. A. Mean differences: early images −0.04 (95 % CI −0.10 to 0.01), R2 = 1.0 e−5; delayed images −0.01 (95 % CI −0.07 to 0.04), R2 = 0.01. B. Mean differences: early images 0.03 (95 % CI −0.01 to 0.08) R2 = 0.01; delayed images 0.06 (95 % CI 0.02–0.10), R2 = 2.2 e−4

Mentions: Interobserver correlations of WH H/M ratios were moderate, of Sm H/M ratios and WO poor (Table 2). However, mean interobserver differences were small for WH H/M ratio (Fig. 2). Intermethod variability, describing the correlation of WH and Sm ROI definition by one observer, demonstrated poor LCCs (Fig. 3).Fig. 2


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)

Bland–Altman plots of interobserver difference versus mean of planar anterior (a) and geometric (b) WH H/M ratio, both on early and on delayed images. Butted lines represent 95 % limits of agreement. A. Mean differences: early images −0.04 (95 % CI −0.10 to 0.01), R2 = 1.0 e−5; delayed images −0.01 (95 % CI −0.07 to 0.04), R2 = 0.01. B. Mean differences: early images 0.03 (95 % CI −0.01 to 0.08) R2 = 0.01; delayed images 0.06 (95 % CI 0.02–0.10), R2 = 2.2 e−4
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig2: Bland–Altman plots of interobserver difference versus mean of planar anterior (a) and geometric (b) WH H/M ratio, both on early and on delayed images. Butted lines represent 95 % limits of agreement. A. Mean differences: early images −0.04 (95 % CI −0.10 to 0.01), R2 = 1.0 e−5; delayed images −0.01 (95 % CI −0.07 to 0.04), R2 = 0.01. B. Mean differences: early images 0.03 (95 % CI −0.01 to 0.08) R2 = 0.01; delayed images 0.06 (95 % CI 0.02–0.10), R2 = 2.2 e−4
Mentions: Interobserver correlations of WH H/M ratios were moderate, of Sm H/M ratios and WO poor (Table 2). However, mean interobserver differences were small for WH H/M ratio (Fig. 2). Intermethod variability, describing the correlation of WH and Sm ROI definition by one observer, demonstrated poor LCCs (Fig. 3).Fig. 2

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