(Sunday, 7/12/2020) [Eastern Time (GMT-4)]
Room: AAPM ePoster Library
Purpose: increased long-term survival in esophageal cancer patients with radiotherapy, radiation-induced cardiac toxicity happens more frequently. The purpose of this study was aiming to investigate change of myocardial [18F]FDG uptake before and after radiotherapy, and relationship between this change and radiation dose on myocardium during therapy.
Methods: patients with thoracic esophageal cancer with radiotherapy were enrolled in Shangdong Tumor Hospital, Jinan, China during 2016-2018. [18F]FDG PET imaging was performed 1-2 week before radiotherapy and 2-3 months after radiotherapy. Prior to PET imaging, patients were fasted over 12 hours.PET imaging data were analyzed using Carimas (developed in Turku PET Centre, Turku, Finland). Radiation dose data were outputted as Dicom image data format (each pixel represents radiation dose). Then it was fused with FDG PET imaging. Left ventricular myocardium (LV-VOI) was segmented based on FDG PET images. Using same LV-VOI, corresponding radiation dose was extracted from radiation dose image. Finally, the relationship between change of FDG PET uptake and radiation dose for left ventricular myocardium was calculated.
Results: myocardial accumulation patterns of FDG PET uptake related to radiation dose were categorized. Uptake of FDG was increased in high radiation dose in four patients, meanwhile, uptake of FDG was decreased in high radiation dose in another four patients. In last two patients, uptake of FDG was not significantly changed with radiation dose. Since without clinical data, it is not possible to correlate the FDG PET uptake pattern with cardiac toxicity in current study.
Conclusion: patients with esophageal cancer with radiotherapy, accumulation of FDG is complicated with increased, decreased or no-change modes related to radiation dose.
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