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SHR Neuro Cancer Cardio Lipid Metab Microb
Machann, W; Beer, M; Breunig, M; Stork, S; Angermann, C; Seufert, I; Schwab, F; Kolbl, O; Flentje, M; Vordermark, D.
CARDIAC MAGNETIC RESONANCE IMAGING FINDINGS IN 20-YEAR SURVIVORS OF MEDIASTINAL RADIOTHERAPY FOR HODGKIN'S DISEASE
Int J Radiat Oncol Biol Phys. 2011; 79(4):1117-1123
Doi: 10.1016/j.ijrobp.2009.12.054
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- Beer Meinrad
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- Abstract:
- Purpose: The recognition of the true prevalence of cardiac toxicity after mediastinal radiotherapy requires very long follow-up and a precise diagnostic procedure. Cardiac magnetic resonance imaging (MRI) permits excellent quantification of cardiac function and identification of localized myocardial defects and has now been applied to a group of 20-year Hodgkin's disease survivors. Methods and materials: Of 1143 patients treated with anterior mediastinal radiotherapy (cobalt-60, median prescribed dose 40 Gy) for Hodgkin's disease between 1978 and 1985, all 53 survivors were invited for cardiac MRI. Of those, 36 patients (68%) presented for MRI, and in 31 patients (58%) MRI could be performed 20-28 years (median, 24) after radiotherapy. The following sequences were acquired on a 1.5-T MRI: transversal T1-weighted TSE and T2-weighted half-fourier acquisition single-shot turbo-spin-echo sequences, a steady-state free precession (SSFP) eine sequence in the short heart axis and in the four-chamber view, SSFP perfusion sequences under rest and adenosine stress, and a SSFP inversion recovery sequence for late enhancement. The MRI findings were correlated with previously reconstructed doses to cardiac structures. Results: Clinical characteristics and reconstructed doses were not significantly different between survivors undergoing and not undergoing MRI. Pathologic findings were reduced left ventricular function (ejection fraction < 55%) in 7(23%) patients, hemodynamically relevant valvular dysfunction in 13(42%), late myocardial enhancement in 9 (29%), and any perfusion deficit in 21(68%). An association of regional pathologic changes and reconstructed dose to cardiac structures could not be established. Conclusions: In 20-year survivors of Hodgkin's disease, cardiac MRI detects pathologic findings in approximately 70% of patients. Cardiac MRI has a potential role in cardiac imaging of Hodgkin's disease patients after mediastinal radiotherapy. (C) 2011 Elsevier Inc.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Aged -
- Cobalt Radioisotopes - therapeutic use
- Female -
- Follow-Up Studies -
- Heart - radiation effects
- Hodgkin Disease - radiotherapy
- Humans -
- Magnetic Resonance Imaging - methods
- Male -
- Middle Aged -
- Radiation Injuries - complications Radiation Injuries - pathology Radiation Injuries - physiopathology
- Radiotherapy Dosage -
- Survivors -
- Time Factors -
- Ventricular Dysfunction, Left - diagnosis Ventricular Dysfunction, Left - physiopathology
- Find related publications in this database (Keywords)
- Hodgkin's Disease
- Radiotherapy
- Heart
- Cardiovascular system
- Toxicity