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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

IRW-derived 123I-mIBG SPECT intermethod differences. Early WH versus LV H/M ratio: mean difference 0.12, LCC 0.99 (95 % CI 0.985–0.994), R2 = 0.20. Delayed WH versus LV H/M ratio: mean difference 0.10, LCC 0.996 (95 % CI 0.993–0.997), R2 = 0.15. Butted lines represent 95 % limits of agreement. The differences can be accounted for by the dilution effect. WO mean difference −0.5 %, LCC 0.993 (95 % CI 0.987–0.996), not included in figure
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Fig4: IRW-derived 123I-mIBG SPECT intermethod differences. Early WH versus LV H/M ratio: mean difference 0.12, LCC 0.99 (95 % CI 0.985–0.994), R2 = 0.20. Delayed WH versus LV H/M ratio: mean difference 0.10, LCC 0.996 (95 % CI 0.993–0.997), R2 = 0.15. Butted lines represent 95 % limits of agreement. The differences can be accounted for by the dilution effect. WO mean difference −0.5 %, LCC 0.993 (95 % CI 0.987–0.996), not included in figure

Mentions: The intermethod correlation of SPECT-derived WH versus LV H/M ratio (both early and late) and WO was almost perfect (LCC 0.99). Mean differences were very small (Fig. 4).Fig. 4


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)

IRW-derived 123I-mIBG SPECT intermethod differences. Early WH versus LV H/M ratio: mean difference 0.12, LCC 0.99 (95 % CI 0.985–0.994), R2 = 0.20. Delayed WH versus LV H/M ratio: mean difference 0.10, LCC 0.996 (95 % CI 0.993–0.997), R2 = 0.15. Butted lines represent 95 % limits of agreement. The differences can be accounted for by the dilution effect. WO mean difference −0.5 %, LCC 0.993 (95 % CI 0.987–0.996), not included in figure
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig4: IRW-derived 123I-mIBG SPECT intermethod differences. Early WH versus LV H/M ratio: mean difference 0.12, LCC 0.99 (95 % CI 0.985–0.994), R2 = 0.20. Delayed WH versus LV H/M ratio: mean difference 0.10, LCC 0.996 (95 % CI 0.993–0.997), R2 = 0.15. Butted lines represent 95 % limits of agreement. The differences can be accounted for by the dilution effect. WO mean difference −0.5 %, LCC 0.993 (95 % CI 0.987–0.996), not included in figure
Mentions: The intermethod correlation of SPECT-derived WH versus LV H/M ratio (both early and late) and WO was almost perfect (LCC 0.99). Mean differences were very small (Fig. 4).Fig. 4

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