Serial assessment of coronary artery inflammation using cardiac CT in anthracycline chemotherapy for breast cancer.

IF 4.7 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING European Radiology Pub Date : 2025-01-21 DOI:10.1007/s00330-025-11347-0

Masafumi Kidoh, Seitaro Oda, Daisuke Sueta, Koichi Egashira, Hidetaka Hayashi, Takeshi Nakaura, Yasunori Nagayama, Yutaka Yamamoto, Kenichi Tsujita, Toshinori Hirai

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Abstract

Objectives: There is limited evidence of the pericoronary fat attenuation index (FAI) as an imaging marker to assess cancer therapy-related cardiovascular toxicity. We aimed to measure FAI in four consecutive coronary CT angiography (CTA) scans before and 3, 6, and 12 months after anthracycline treatment in patients with breast cancer to determine trends in dynamic changes in FAI after treatment.

Methods: We performed a post hoc analysis of a prospective study (between August 2019 and July 2020) in which anthracycline-induced myocardial injury was evaluated using cardiac CT. FAI was quantified using coronary CTA images before and 3, 6, and 12 months after anthracycline treatment. The FAIs of the three coronary arteries were averaged to calculate the FAI (Total).

Results: FAI was analyzed on 14 patients with breast cancer who had adequate CT image quality (mean age, 62 years ± 11 (SD); 14 women). During the observation period, all 14 patients treated with anthracycline developed mild asymptomatic cardiac dysfunction related to cancer treatment (CTRCD). FAI (Total) showed a gradual increase during the observation period compared to baseline (baseline: -77.3 ± 5.6 HU, 3 months: -77.1 ± 4.8 HU, 6 months: -76.5 ± 5.4 HU, 12 months: -73.8 ± 5.8 HU). FAI (Total) was significantly elevated at 12 months compared to baseline (p < 0.001).

Conclusion: In patients with breast cancer, FAI showed a gradual increase at 3, 6, and 12 months after treatment with anthracyclines compared to before treatment. FAI may be used as an imaging biomarker of coronary artery inflammation in the follow-up of anthracycline therapy and may contribute to the personalization of therapy through early detection of coronary toxicity.

Key points: Question Is pericoronary fat attenuation index (FAI) a potential imaging biomarker for assessing changes in pericoronary adipose tissue related to cancer therapy-related cardiovascular toxicity? Findings In 14 patients with breast cancer, FAI showed a gradual increase at 3, 6, and 12 months after treatment with anthracyclines compared to before treatment. Clinical relevance FAI may be an imaging biomarker for the detection and treatment of cancer therapy-related cardiovascular toxicity.

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蒽环类药物治疗乳腺癌患者冠状动脉炎症的心脏CT系列评价。

目的：有有限的证据表明冠状动脉周围脂肪衰减指数（FAI）作为评估癌症治疗相关心血管毒性的影像学标志物。我们的目的是测量乳腺癌患者在蒽环类药物治疗前和治疗后3,6和12个月连续四次冠状动脉CT血管造影（CTA）扫描的FAI，以确定治疗后FAI的动态变化趋势。方法：我们对一项前瞻性研究（2019年8月至2020年7月）进行了事后分析，该研究使用心脏CT评估蒽环类药物引起的心肌损伤。在蒽环类药物治疗前、治疗后3个月、6个月和12个月使用冠状动脉CTA图像量化FAI。取三条冠状动脉的FAI平均值，计算FAI （Total）。结果：对14例CT图像质量良好的乳腺癌患者(平均年龄62岁±11岁（SD）；14女)。在观察期内，14例蒽环类药物治疗的患者均出现与癌症治疗相关的轻度无症状心功能障碍（CTRCD）。FAI （Total）在观察期内与基线相比逐渐升高（基线：-77.3±5.6 HU， 3个月：-77.1±4.8 HU， 6个月：-76.5±5.4 HU， 12个月：-73.8±5.8 HU）。与基线相比，FAI （Total）在12个月时显著升高(p)。结论：在乳腺癌患者中，与治疗前相比，蒽环类药物治疗后3、6和12个月的FAI逐渐增加。在蒽环类药物治疗的随访中，FAI可作为冠状动脉炎症的成像生物标志物，并可通过早期发现冠状动脉毒性来促进治疗的个性化。冠状动脉脂肪衰减指数（FAI）是评估与癌症治疗相关的心血管毒性相关的冠状动脉脂肪组织变化的潜在成像生物标志物吗？在14例乳腺癌患者中，与治疗前相比，蒽环类药物治疗后3、6和12个月的FAI逐渐增加。临床相关性FAI可能是检测和治疗癌症治疗相关心血管毒性的成像生物标志物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Radiology 医学-核医学

CiteScore

11.60

自引率

8.50%

发文量

874

审稿时长

2-4 weeks

期刊介绍： European Radiology (ER) continuously updates scientific knowledge in radiology by publication of strong original articles and state-of-the-art reviews written by leading radiologists. A well balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes ER an indispensable source for current information in this field. This is the Journal of the European Society of Radiology, and the official journal of a number of societies. From 2004-2008 supplements to European Radiology were published under its companion, European Radiology Supplements, ISSN 1613-3749.