Value of 18F-FDG PET/CT in the detection of the anthracycline induced cardiotoxicity in non-Hodgkin lymphoma / 中华核医学与分子影像杂志

ABSTRACT

Objective:To evaluate the value of standardized uptake value of the left ventricle (SUV LV) during 18F-fluorodeoxyglucose (FDG) PET/CT imaging in the detection of the cardiotoxicity of anthracycline in non-Hodgkin lymphoma (NHL). Methods:Twenty-two patients(13 males and 9 females, age ( 58±13 ) years) diagnosed as NHL from January 2016 to June 2019 were retrospectively enrolled in the study. All patients received chemotherapy regimens containing anthracycline. The gated myocardial perfusion imaging (GMPI) and whole body 18F-FDG PET/CT imaging were performed before and after chemotherapy in Changzhou First People′s Hospital. The significant reduction of diastolic function after chemotherapy measured by GMPI was defined as anthracycline induced myocardial injury. The SUV LV before and after chemotherapy and the changes (&Delta;SUV LV ) in patients with or without myocardial injury were compared with independent-sample t test or paired t test. The receiver operating characteristic (ROC) curve analysis was used to determine whether SUV LV could be used to detect anthracycline induced myocardial injury. Results:The reduction of LVEF after chemotherapy was more significant in myocardial injury group ( n=6) than that in patients without myocardial injury ( n=16; &Delta;LVEF (-5.8±7.5)% vs (2.7±3.8)%, t=2.657, P<0.05). After chemotherapy, an increase was found in SUV LV of patients with myocardial injury (maximum SUV LV (SUV LVmax) 7.5±4.4 vs 2.6±1.0, t=2.585, P<0.05; mean SUV LV (SUV LVmean) 3.7±2.2 vs 1.6±0.8, t=2.119, P>0.05), but no differences were found in SUV LV of patients without myocardial injury (SUV LVmax 5.7±4.9 vs 5.6±4.8, SUV LVmean 2.8±2.3 vs 2.8±2.2; t values 0.130, 0.069, both P>0.05). Compared with patients without myocardial injury, patients with myocardial injury had higher &Delta;SUV LV ( t values 2.494, 2.163, both P<0.05) and lower pre-chemotherapy SUV LVmax ( t=2.436, P<0.05). ROC curve analysis showed that &Delta;SUV LVmax and &Delta;SUV LVmean could be used for the detection of chemotherapy induced cardiotoxicity, and higher area under curve (AUC) of &Delta;SUV LVmaxwas found (AUC=0.844, 95% CI 0.673-1.000). When the threshold value was 1.1, the sensitivity and specificity of &Delta;SUV LVmax in the detection of myocardial injury were 5/6 and 13/16, respectively. Conclusions:Higher &Delta;SUV LVmax and &Delta;SUV LVmean, as well as lower baseline SUV LVmax are correlated with cardiotoxicity of anthracycline. &Delta;SUV LVmax has a potential for the diagnosis of anthracycline induced cardiotoxicity in patients with NHL.