(123) I-MIBG imaging for detection of anthracycline-induced cardiomyopathy.

Research paper by Adam H AH Laursen, Jens Jakob JJ Thune, Martin M Hutchings, Philip P Hasbak, Andreas A Kjaer, Marie B MB Elming, Rasmus S RS Ripa

Indexed on: 03 Mar '17Published on: 03 Mar '17Published in: Clinical Physiology and Functional Imaging


Due to improvements in early detection and treatment of malignant disease, the population of cancer survivors is constantly expanding. Cancer survivors are faced with chemotherapy-related long-term side effects, including irreversible cardiac injury with risk of heart failure (HF). Numerous antineoplastic regimens are associated with risk of cardiac side effects, but anthracyclines in particular carry a severe risk of cardiotoxicity. Currently, serial echocardiographic evaluation of resting left ventricular ejection fraction (LVEF) is the gold standard for monitoring anthracycline-induced cardiac side effects from chemotherapy. LVEF measurements are, however, limited by their low sensitivity. A normal LVEF does not exclude cardiotoxicity and declines in LVEF are usually not observed before the occurrence of irreversible cardiomyopathy. Hence, a clinically applicable high-sensitivity diagnostic tool for early detection of chemotherapy-related cardiotoxicity is still lacking and alternative non-invasive imaging modalities are therefore being investigated. (123) I-MIBG is a noradrenaline (NA) analogue used for evaluation of cardiac adrenergic function, including assessment of HF prognosis and evaluation of HF treatment response. However, the role of (123) I-MIBG for monitoring chemotherapy-related cardiotoxicity is still unclear. Here, we review the value of (123) I-MIBG imaging for early detection and prevention of anthracycline-induced cardiomyopathy.

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