Orit Kaidar-Person1,2, Timothy M Zagar1,2, Jorge Daniel Oldan3,2, Jason Matney1,2, Ellen L Jones1,2, Shiva Das1,2, Brian C Jensen4,5, Richard C Zellars6, Terence Z Wong3,2, Lawrence B Marks7,8. 1. Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC, USA. 2. UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA. 3. Department of Radiology, University of North Carolina, Chapel Hill, NC, USA. 4. Department of Medicine/Division of Cardiology, UNC, Chapel Hill, NC, USA. 5. UNC McAllister Heart Institute, Chapel Hill, NC, USA. 6. Department of Radiation Oncology, Indiana University, Bloomington, IN, USA. 7. Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC, USA. lawrence_marks@med.unc.edu. 8. UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA. lawrence_marks@med.unc.edu.
Abstract
PURPOSE: Cardiac single-photon emission computed tomography (SPECT) is often used to identify defects in myocardial perfusion due to atherosclerotic coronary artery disease. It was also used in studies to evaluate radiation therapy (RT)-associated cardiac abnormalities. In the current review, we aim to evaluate the rates of post-RT cardiac SPECT early perfusion abnormalities and relate this to the irradiated left ventricular volume. METHODS: The studies cited in this systematic review were identified using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. RESULTS: Six studies between 1996 and 2016 fulfilled the inclusion criteria. The reported perfusion defects in these studies were seen in the apical and anterolateral aspects of the left ventricle. Three studies show correlation between the percent of the left ventricle within the RT-field and percent of patients with early perfusion defects on cardiac SPECT. In two studies that used cardiac sparing techniques (such as deep inspiration), that resulted in a low mean heart dose, no perfusion defects were noted. CONCLUSIONS: Data suggest that incidental irradiation of the heart in cases of left breast/chest wall RT can result in early post-RT perfusion defects on cardiac SPECT. There appears to be strong dose/volume dependence to the risk, and hence techniques to reduce cardiac exposure are recommended.
PURPOSE: Cardiac single-photon emission computed tomography (SPECT) is often used to identify defects in myocardial perfusion due to atherosclerotic coronary artery disease. It was also used in studies to evaluate radiation therapy (RT)-associated cardiac abnormalities. In the current review, we aim to evaluate the rates of post-RT cardiac SPECT early perfusion abnormalities and relate this to the irradiated left ventricular volume. METHODS: The studies cited in this systematic review were identified using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. RESULTS: Six studies between 1996 and 2016 fulfilled the inclusion criteria. The reported perfusion defects in these studies were seen in the apical and anterolateral aspects of the left ventricle. Three studies show correlation between the percent of the left ventricle within the RT-field and percent of patients with early perfusion defects on cardiac SPECT. In two studies that used cardiac sparing techniques (such as deep inspiration), that resulted in a low mean heart dose, no perfusion defects were noted. CONCLUSIONS: Data suggest that incidental irradiation of the heart in cases of left breast/chest wall RT can result in early post-RT perfusion defects on cardiac SPECT. There appears to be strong dose/volume dependence to the risk, and hence techniques to reduce cardiac exposure are recommended.
Authors: Stefanie Corradini; Hendrik Ballhausen; Helmut Weingandt; Philipp Freislederer; Stephan Schönecker; Maximilian Niyazi; Cristoforo Simonetto; Markus Eidemüller; Ute Ganswindt; Claus Belka Journal: Strahlenther Onkol Date: 2017-09-15 Impact factor: 3.621
Authors: Oi-Wai Chau; Ali Islam; Edward Yu; Melody Qu; John Butler; Heather Biernaski; Alexander Sun; Jean-Pierre Bissonnette; Anna MacDonald; Chantelle Graf; Aaron So; Gerald Wisenberg; Ting-Yim Lee; Frank S Prato; Stewart Gaede Journal: Adv Radiat Oncol Date: 2022-02-27