Myocardial extracellular volume derived from contrast-enhanced chest computed tomography for longitudinal evaluation of cardiotoxicity in patients with breast cancer treated with anthracyclines.

OBJECTIVES

To assess the value of myocardial extracellular volume (ECV) derived from contrast-enhanced chest computed tomography (CT) for longitudinal evaluation of cardiotoxicity in patients with breast cancer (BC) treated with anthracycline (AC).

MATERIALS AND METHODS

A total of 1151 patients with BC treated with anthracyclines, who underwent at least baseline, and first follow-up contrast-enhanced chest CT were evaluated. ECV and left ventricular ejection fraction (LVEF) were measured before (ECV, LVEF), during ((ECV, LVEF) and (ECV, LVEF)), and after (ECV, LVEF) AC treatment. ECV values were evaluated at the middle of left ventricular septum on venous phase images. Cancer therapy-related cardiac dysfunction (CTRCD) was recorded.

RESULTS

Mean baseline LVEF values were 65.85% ± 2.72% and 102 patients developed CTRCD. The mean ECV was 26.76% ± 3.03% (N = 1151). ECV, ECV, and ECV (median interval: 61 (IQR, 46-75), 180 (IQR, 170-190), 350 (IQR, 341-360) days from baseline) were 31.32% ± 3.10%, 29.60% ± 3.24%, and 32.05% ± 3.58% (N = 1151, N = 841, N = 511). ECV, ECV, and ECV were significantly higher than ECV (p < 0.001). ECV and ECV showed no difference between CTRCD (+) and CTRCD (-) group (p = 0.150; p = 0.216). However, ECV and ECV showed significant differences between the two groups (p < 0.001; p < 0.001).

CONCLUSION

CT-derived ECV is a potential biomarker for dynamic monitoring AC cardiotoxicity in patients with BC.