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The Capital Region of Denmark - a part of Copenhagen University Hospital
E-pub ahead of print

Rubidium-82 positron emission tomography for detection of acute doxorubicin-induced cardiac effects in lymphoma patients

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  1. 123I-MIBG for detection of subacute doxorubicin-induced cardiotoxicity in patients with malignant lymphoma

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  2. Stomach interference in 82Rb-PET myocardial perfusion imaging

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BACKGROUND: Doxorubicin is a cornerstone in lymphoma treatment, but is limited by dose-dependent cardiotoxicity. Rubidium-82 positron emission tomography (82Rb PET) assesses coronary microvascular function through absolute quantification of myocardial perfusion and myocardial perfusion reserve (MPR). Doxorubicin-induced microvascular injury represents a potential early marker of cardiotoxicity.

METHODS AND RESULTS: We included 70 lymphoma patients scheduled for doxorubicin-based treatment. Cardiotoxicity was evaluated with 82Rb PET myocardial perfusion imaging during rest and adenosine stress before chemotherapy and shortly after the first doxorubicin exposure. Patients with a MPR decline > 20% were defined as having a low threshold for cardiotoxicity. In the 54 patients with complete data sets, MPR was significantly lower after the initial doxorubicin exposure (2.69 vs 2.51, P = .03). We registered a non-significant decline in stress perfusion (3.18 vs 3.02 ml/g/min, P = .08), but no change in resting myocardial perfusion. There were 13 patients with a low cardiotoxic threshold. These patients had a significantly higher age, but were otherwise similar to the remaining part of the study population.

CONCLUSION: Decreases in MPR after initial doxorubicin exposure in lymphoma patients may represent an early marker of doxorubicin-induced cardiotoxicity. The prognostic value of acute doxorubicin-induced changes in MPR remains to be investigated.

Original languageEnglish
JournalJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology
Pages (from-to)1-10
ISSN1071-3581
DOIs
Publication statusE-pub ahead of print - 2018

ID: 55722251