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Early Detection of Changes in Myocardial 18F-FDG Uptake Before and After Radiotherapy Using 17 Segment Model in Patients with Esophageal Cancer

X Sha, G Gong, Y Yin*, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan , China


(Sunday, 7/12/2020)   [Eastern Time (GMT-4)]

Room: AAPM ePoster Library

Purpose: aim of this study was to investigate changes in myocardial uptake following radiotherapy (RT) evaluated by oncologic 18F-?uorodeoxyglucose (FDG) PET/CT scans and to determine relationship between myocardial 18F-FDG uptake and the irradiated dose in esophageal cancer (EC) patients who underwent radiotherapy (RT).

Methods: EC patients who performed consecutive oncologic 18F-FDG PET/CT scan at baseline and post-RT were enrolled. Delineation of segmental myocardium was undertaken on PET images, and then registered to RT planning CT images. Individual segments were then combined to determine 18F-FDG uptake and doses to the basal, mid and apical regions. Uptake pattern in myocardium, the mean SUV and the change of SUV between baseline and post-RT PET/CT in the myocardial segments, and changes of myocardium uptake within different dose ranges were measured by quantitative analysis.

Results: accumulation of 18F-FDG were categorized with increased (3 patients), decreased (6 patients) or no changes (3 patients) pattern. And a heterogeneous dose distribution was observed, with the basal region receiving the highest median mean dose (18.36 Gy) compared with the middle and apical regions (5.30 Gy and 2.21 Gy, respectively). In the segmental analysis, 18F-FDG uptake decreased 28.93% and 12.12% after RT in the low-dose segments (0-10 Gy and 10-20 Gy), while increased 7.24% in the high-dose segments (20-30 Gy).

Conclusion: increase of SUV of myocardium on post-RT PET/CT were associated with the irradiated dose in EC patients. Determining the 18F-FDG uptake and corresponding RT dose in the myocardial segments can help to guide focus in the diagnosis of radiation-induced cardiac toxicity.


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