Harada Yuko, Shimada Kyosuke, Harada Satoshi John, Sato Tomomi, Kubota Yukino, Yamashita Miyoko
Department of Cardiology, Kawasaki Municipal Ida Hospital, Kawasaki 211-0035, Japan.
Department of Breast Surgery, Kawasaki Municipal Ida Hospital, Kawasaki 211-0035, Japan.
J Imaging. 2022 Oct 29;8(11):296. doi: 10.3390/jimaging8110296.
(1) Background: The mortality of breast cancer has decreased due to the advancement of cancer therapies. However, more patients are suffering from cancer-therapeutics-related cardiac dysfunction (CTRCD). Diagnostic and treatment guidelines for CTRCD have not been fully established yet. Ultrasound cardiogram (UCG) is the gold standard for diagnosis of CTRCD, but many breast cancer patients cannot undergo UCG due to the surgery wounds or anatomical reasons. The purpose of the study is to evaluate the usefulness of myocardial scintigraphy using Iodine-123 β-methyl-P-iodophenyl-pentadecanoic acid (I-BMIPP) in comparison with UCG. (2) Methods: 100 breast cancer patients who received chemotherapy within 3 years underwent Thallium (Tl) and I-BMIPP myocardial perfusion and metabolism scintigraphy. The images were visually evaluated by doctors and radiological technologists, and the grade of uptake reduction was scored by Heart Risk View-S software (Nihon Medi-Physics). The scores were deployed in a 17-segment model of the heart. The distribution of the scores were analyzed. (3) Results: Nine patients (9%) could not undergo UCG. No correlation was found between left ventricular ejection fraction (LVEF) and Heart Risk View-S scores of Tl myocardial perfusion scintigraphy nor those of BMIPP myocardial metabolism scintigraphy. In a 17-segment model of the heart, the scores of the middle rings were higher than for the basal ring. (4) Conclusions: Evaluation by UCG is not possible for some patients. Myocardial scintigraphy cannot serve as a perfect alternative to UCG. However, it will become the preferable second-choice screening test, as it could point out the early stage of CTRCD.
（1）背景：由于癌症治疗技术的进步，乳腺癌死亡率有所下降。然而，越来越多的患者正遭受与癌症治疗相关的心脏功能障碍（CTRCD）之苦。CTRCD的诊断和治疗指南尚未完全确立。超声心动图（UCG）是CTRCD诊断的金标准，但许多乳腺癌患者因手术伤口或解剖学原因无法进行UCG检查。本研究的目的是评估使用碘-123β-甲基-P-碘代苯基十五烷酸（I-BMIPP）的心肌闪烁显像与UCG相比的实用性。（2）方法：对100例在3年内接受化疗的乳腺癌患者进行铊（Tl）和I-BMIPP心肌灌注及代谢闪烁显像。图像由医生和放射技师进行视觉评估，并通过心脏风险视图-S软件（日本医学物理公司）对摄取减少程度进行评分。评分采用心脏的17节段模型。分析评分的分布情况。（3）结果：9例患者（9%）无法进行UCG检查。左心室射血分数（LVEF）与Tl心肌灌注闪烁显像或BMIPP心肌代谢闪烁显像的心脏风险视图-S评分之间均未发现相关性。在心脏的17节段模型中，中间节段的评分高于基底部节段。（4）结论：部分患者无法通过UCG进行评估。心肌闪烁显像不能完全替代UCG。然而，它将成为更可取的第二选择筛查测试，因为它可以指出CTRCD的早期阶段。
