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Early Detection of Radiation-Induced Myocardial Injury Using 18F-FDG PET Imaging in Patients with Esophageal Cancer During Radiotherapy

X Sha*, G Gong , Q Qiu , Y Yin , shandong cancer hospital, Jinan, 250117


(Sunday, 7/14/2019)  

Room: ePoster Forums

Purpose: This study was to investigate the value of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) imaging in the detection of radiation-induced myocardial injury in specific left ventricle (LV) segments for EC patients, and to analyze the correlation between the variation of FDG uptake value during radiotherapy (RT) and the received dose.

Methods: The 18F-FDG PET scan was acquired both pre-RT and post-RT within one to three months. Twenty-six patients with middle thoracic EC were enrolled in the study, according to the maximal standardized uptake value (SUVmax), their myocardial accumulation patterns of FDG were categorized into two types: physiological (12 patients), focal and without pathological accumulation (14 patients). Textural features derived from left ventricular muscle (LVM) both pre-RT and post-RT were quantitatively analyzed by CGITA software. The results of the PET metabolism were quantitatively evaluated with Carimas software from a polar bull-eye map, which rearranged the myocardium circumferential profile image from apex to base as 3 segments, 4 segments and 17 segments as per the American Heart Association (AHA). Then the correlation between the changes of the PET parameters and the RT dose was analyzed.

Results: A total of 108 features were extracted from LVM. There were 15 and 5 features which had statistical differences between pre-RT and post-RT images, respectively(P<0.05).In the physiological accumulation group, compared with the FDG uptake of the pre-RT, the imaging during RT showed significant decrement in LAD (1/3 segments), LCX (2/3 segments,3/4 segments), and Apex (1/4 segments, 1-9/17 segments) (P<0.05). The reduction of FDG uptake was significantly correlate with the level of dose received (P<0.05).

Conclusion: 18F-FDG PET can detect the FDG uptake of specific LV segments using the polar map quantitative analysis method, which would be useful to early diagnose radiation-induced myocardial injury.


Radiation Risk, PET, Quantitative Imaging


IM- PET : Radiation dosimetry & risk

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