Saito K, Takeda K, Okamoto S, Okamoto R, Makino K, Tameda Y, Nomura Y, Maeda H, Ichihara T, Nakano T
Department of Internal Medicine, Yamamoto General Hospital, Kuwana, Mie, Japan.
J Nucl Cardiol. 2000 Nov-Dec;7(6):553-61. doi: 10.1067/mnc.2000.108351.
To evaluate the possibility of predicting the development of doxorubicin-induced cardiomyopathy, we performed quantitative assessment of the early kinetics of iodine-123 beta-methyl-iodophenyl-pentadecanoic acid (I-123 BMIPP) by means of dynamic myocardial SPECT.
Thirty-six patients with various malignancies were examined. I-123 BMIPP dynamic myocardial SPECT was performed before chemotherapy, after chemotherapy, or both. Immediately after the injection of I-123 BMIPP (111 MBq), 30-second dynamic SPECT data were acquired successively for 15 minutes. The left ventricular (LV) myocardium was divided into 8 segments in short-axial and vertical slices. By using the time-activity curve (TAC) of each myocardial segment [Mo(t)] as an output function and the TAC of the LV cavity [B(t)] as an input function, the Rutland equation, Mo(t)/B(t)= F + K Integral of(B(t)dt/B(t)), was used as a means of assessing all segments.
Mo(t)/B(t) showed a good linear correlation with Integral of(B(t)dt/B(t)) from 30 seconds to 4 minutes in all 456 segments. The mean K value of 8 LV segments was significantly lower after chemotherapy than before chemotherapy (0.071+/-0.019 [n = 21] vs. 0.095+/-0.025 [n = 36], P<.001). In 21 patients in whom dynamic SPECT was performed both before and after chemotherapy, the mean K values of left ventricle showed a significant decrease, from 0.101+/-0.024 to 0.071 +/-0.019 (P<.0001). The fractional change in the value of K after chemotherapy showed a significant linear correlation with the administered dose of doxorubicin (r = 0.648, P<.002).
I-123 BMIPP dynamic myocardial SPECT may be clinically useful, because it permits the early detection of doxorubicin-induced cardiomyopathy.
为评估预测阿霉素诱发心肌病发展的可能性，我们通过动态心肌单光子发射计算机断层扫描（SPECT）对碘-123β-甲基-碘代苯基十五烷酸（I-123 BMIPP）的早期动力学进行了定量评估。
对36例患有各种恶性肿瘤的患者进行了检查。在化疗前、化疗后或两者均进行了I-123 BMIPP动态心肌SPECT检查。在注射I-123 BMIPP（111 MBq）后，立即连续采集30秒的动态SPECT数据，持续15分钟。左心室（LV）心肌在短轴和垂直切片中被分为8个节段。通过将每个心肌节段的时间-活性曲线（TAC）[Mo(t)]作为输出函数，将左心室腔的TAC[B(t)]作为输入函数，使用Rutland方程Mo(t)/B(t)=F + K∫(B(t)dt/B(t))来评估所有节段。
在所有456个节段中，Mo(t)/B(t)在30秒至4分钟内与∫(B(t)dt/B(t))呈现出良好的线性相关性。化疗后左心室8个节段的平均K值显著低于化疗前（0.071±0.019 [n = 21] 对比 0.095±0.025 [n = 36]，P<.001）。在21例化疗前后均进行动态SPECT检查的患者中，左心室的平均K值显著下降，从0.101±0.024降至0.071±0.019（P<.0001）。化疗后K值的分数变化与阿霉素的给药剂量呈现出显著的线性相关性（r = 0.648，P<.002）。
I-123 BMIPP动态心肌SPECT可能在临床上有用，因为它能够早期检测出阿霉素诱发的心肌病。
