Kidoh Masafumi, Oda Seitaro, Sueta Daisuke, Egashira Koichi, Hayashi Hidetaka, Nakaura Takeshi, Nagayama Yasunori, Yamamoto Yutaka, Tsujita Kenichi, Hirai Toshinori
Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
Eur Radiol. 2025 Jan 21. doi: 10.1007/s00330-025-11347-0.
There is limited evidence of the pericoronary fat attenuation index (FAI) as an imaging marker to assess cancer therapy-related cardiovascular toxicity. We aimed to measure FAI in four consecutive coronary CT angiography (CTA) scans before and 3, 6, and 12 months after anthracycline treatment in patients with breast cancer to determine trends in dynamic changes in FAI after treatment.
We performed a post hoc analysis of a prospective study (between August 2019 and July 2020) in which anthracycline-induced myocardial injury was evaluated using cardiac CT. FAI was quantified using coronary CTA images before and 3, 6, and 12 months after anthracycline treatment. The FAIs of the three coronary arteries were averaged to calculate the FAI (Total).
FAI was analyzed on 14 patients with breast cancer who had adequate CT image quality (mean age, 62 years ± 11 (SD); 14 women). During the observation period, all 14 patients treated with anthracycline developed mild asymptomatic cardiac dysfunction related to cancer treatment (CTRCD). FAI (Total) showed a gradual increase during the observation period compared to baseline (baseline: -77.3 ± 5.6 HU, 3 months: -77.1 ± 4.8 HU, 6 months: -76.5 ± 5.4 HU, 12 months: -73.8 ± 5.8 HU). FAI (Total) was significantly elevated at 12 months compared to baseline (p < 0.001).
In patients with breast cancer, FAI showed a gradual increase at 3, 6, and 12 months after treatment with anthracyclines compared to before treatment. FAI may be used as an imaging biomarker of coronary artery inflammation in the follow-up of anthracycline therapy and may contribute to the personalization of therapy through early detection of coronary toxicity.
Question Is pericoronary fat attenuation index (FAI) a potential imaging biomarker for assessing changes in pericoronary adipose tissue related to cancer therapy-related cardiovascular toxicity? Findings In 14 patients with breast cancer, FAI showed a gradual increase at 3, 6, and 12 months after treatment with anthracyclines compared to before treatment. Clinical relevance FAI may be an imaging biomarker for the detection and treatment of cancer therapy-related cardiovascular toxicity.
作为评估癌症治疗相关心血管毒性的成像标志物，冠状动脉周围脂肪衰减指数（FAI）的证据有限。我们旨在对乳腺癌患者在蒽环类药物治疗前及治疗后3、6和12个月的连续四次冠状动脉CT血管造影（CTA）扫描中测量FAI，以确定治疗后FAI的动态变化趋势。
我们对一项前瞻性研究（2019年8月至2020年7月）进行了事后分析，该研究使用心脏CT评估蒽环类药物引起的心肌损伤。在蒽环类药物治疗前及治疗后3、6和12个月，使用冠状动脉CTA图像对FAI进行量化。将三根冠状动脉的FAI进行平均以计算FAI（总计）。
对14例乳腺癌患者进行了FAI分析，这些患者的CT图像质量良好（平均年龄62岁±11（标准差）；14名女性）。在观察期内，所有14例接受蒽环类药物治疗的患者均出现了与癌症治疗相关的轻度无症状心脏功能障碍（CTRCD）。与基线相比，观察期内FAI（总计）呈逐渐升高趋势（基线：-77.3±5.6HU，3个月：-77.1±4.8HU，6个月：-76.5±5.4HU，12个月：-73.8±5.8HU）。与基线相比，12个月时FAI（总计）显著升高（p<0.001）。
在乳腺癌患者中，与治疗前相比，蒽环类药物治疗后3、6和12个月FAI呈逐渐升高趋势。FAI可作为蒽环类药物治疗随访中冠状动脉炎症的成像生物标志物，并可能通过早期检测冠状动脉毒性有助于治疗的个性化。
问题冠状动脉周围脂肪衰减指数（FAI）是否是评估与癌症治疗相关心血管毒性相关的冠状动脉周围脂肪组织变化的潜在成像生物标志物？研究结果在14例乳腺癌患者中，与治疗前相比，蒽环类药物治疗后3、6和12个月FAI呈逐渐升高趋势。临床意义FAI可能是检测和治疗癌症治疗相关心血管毒性的成像生物标志物。
