Progression of Myocardial 18F-FDG Uptake in a Patient with Cardiotoxicity.

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  • Additional Information
    • Transliterated Title:
      Evolução da Captação Miocárdica de 18F-FDG em Paciente com Diagnóstico de Cardiotoxicidade.
    • Source:
      Publisher: Sociedad Brasileira De Cardiologia Country of Publication: Brazil NLM ID: 0421031 Publication Model: eCollection Cited Medium: Internet ISSN: 1678-4170 (Electronic) Linking ISSN: 0066782X NLM ISO Abbreviation: Arq Bras Cardiol Subsets: MEDLINE
    • Publication Information:
      Original Publication: Sao Paulo : Sociedad Brasileira De Cardiologia
    • Subject Terms:
      Lymphoma* ; Heart Failure*/chemically induced ; Heart Failure*/diagnostic imaging; Female ; Humans ; Adult ; Fluorodeoxyglucose F18/metabolism ; Positron Emission Tomography Computed Tomography/methods ; Cardiotoxicity/diagnostic imaging ; Cardiotoxicity/etiology ; Stroke Volume ; Retrospective Studies ; Ventricular Function, Left
    • Abstract:
      The objective of this case report was to present the progression of chemotherapy-induced cardiotoxicity in a patient with lymphoma, highlighting the importance of myocardial fluor-18-fluorodeoxyglucose (18F-FDG) uptake by positron emission tomography coupled with computed tomography (PET/CT). 43-year-old female patient with uterine lymphoma, who underwent hysterectomy followed by three chemotherapy regimens and radiotherapy. The patient had episodes of acute heart failure two years after chemotherapy. Echocardiogram revealed a reduction in left ventricular ejection fraction (LVEF). A retrospective analysis of 18F-FDG PET/CT showed an increase in myocardial uptake in all tests performed during oncologic treatment. Despite disease remission, the patient developed heart failure with reduced LVEF. During chemotherapy, there was a diffuse, significant increase in myocardial 18F-FDG uptake, which preceded the decrease in myocardial performance and seemed to reflect metabolic changes in cardiomyocytes, related to cardiotoxicity. Would an analysis of myocardial 18F-FDG uptake yield a different cardiac outcome in this patient? This question is relevant, considering that other patients may benefit from the use of PET as an early marker of cardiotoxicity. Imaging tests are essential in the follow-up of patients at risk of cardiotoxicity. Although echocardiography remains the main imaging test in the diagnosis of cardiotoxicity, 18F-FDG PET/CT may be a powerful tool for the early diagnosis of this condition.
    • References:
      J Nucl Cardiol. 2020 Aug;27(4):1296-1305. (PMID: 32016692)
      J Nucl Med. 2017 Oct;58(10):1638-1645. (PMID: 28646013)
      J Nucl Cardiol. 2020 Dec;27(6):2154-2163. (PMID: 30719656)
      World J Radiol. 2012 May 28;4(5):220-3. (PMID: 22761982)
      Cardiooncology. 2023 Mar 27;9(1):17. (PMID: 36973762)
      J Transl Med. 2018 Oct 25;16(1):295. (PMID: 30359253)
      Arq Bras Cardiol. 2022 May 02;118(6):1049-1058. (PMID: 35703659)
      Arq Bras Cardiol. 2020 Nov;115(5):1006-1043. (PMID: 33295473)
      Eur Heart J. 2022 Nov 1;43(41):4229-4361. (PMID: 36017568)
      J Intern Med. 2018 Oct;284(4):358-376. (PMID: 29989234)
    • Contributed Indexing:
      Local Abstract: [Publisher, Portuguese] O objetivo deste relato é mostrar a evolução da cardiotoxicidade (CTX) por quimioterápicos em paciente com linfoma por exames de imagens, destacando a importância da captação miocárdica de flúor-18 fluordeoxiglicose (18F-FDG) pela tomografia por emissão de pósitrons, acoplada à tomografia computadorizada (PET/CT). Feminino, 43 anos, com linfoma uterino, submetida a histerectomia, três esquemas de quimioterapia (QT), sucessivamente, e radioterapia. Apresentou episódios de insuficiência cardíaca aguda dois anos após QT. Ecocardiograma mostrou redução da fração de ejeção do ventrículo esquerdo (FEVE). Análise retrospectiva do 18F-FDG PET/CT observou elevação da captação miocárdica em todos os exames durante o seguimento oncológico. Apesar da remissão oncológica, a paciente desenvolveu IC com FEVE reduzida. Durante a QT, ocorreu aumento difuso e significativo da captação miocárdica de 18F-FDG, que precedeu a queda do desempenho cardíaco, e pareceu refletir alterações metabólicas nos cardiomiócitos relacionadas à CTX. A análise da captação miocárdica de 18F-FDG modificaria o desfecho cardiológico da paciente? Esse questionamento é relevante, visto que outros pacientes podem se beneficiar desse método como marcador precoce de CTX. Os exames de imagem são imprescindíveis no acompanhamento de pacientes com risco de CTX. O ecocardiograma permanece como principal auxílio diagnóstico, porém o 18F-FDG PET/CT pode estar surgindo como uma poderosa ferramenta para um diagnóstico mais precoce dessa condição clínica.
    • Accession Number:
      0Z5B2CJX4D (Fluorodeoxyglucose F18)
    • Publication Date:
      Date Created: 20240229 Date Completed: 20240304 Latest Revision: 20240511
    • Publication Date:
      20240511
    • Accession Number:
      PMC11081128
    • Accession Number:
      10.36660/abc.20230276
    • Accession Number:
      38422307