1
|
Garg M, Gandhi K, Gera P, Jadhav SM, Mohanty B, Gurjar M, Sandupatla B, Gala R, Chaudhari P, Prasad M, Chinnaswamy G, Gota V. Implications of chronic moderate protein-deficiency malnutrition on doxorubicin pharmacokinetics and cardiotoxicity in early post-weaning stage. Life Sci 2024; 350:122765. [PMID: 38830506 DOI: 10.1016/j.lfs.2024.122765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 03/14/2024] [Accepted: 05/29/2024] [Indexed: 06/05/2024]
Abstract
BACKGROUND Malnutrition is a common problem in developing countries, and the impact of severe malnutrition on optimal treatment outcomes of chemotherapy in pediatric cancer patients is well documented. However, despite being a more prevalent and distinct entity, moderate malnutrition is until now unexplored for its effects on treatment outcomes. AIMS In this study we aimed to investigate the molecular basis of altered pharmacokinetics and cardiotoxicity of doxorubicin observed in early-life chronic moderate protein deficiency malnutrition. MATERIALS AND METHODS We developed an animal model of early-life moderate protein-deficiency malnutrition and validated it using clinical samples. This model was used to study pharmacokinetic and toxicity changes and was further utilized to study the molecular changes in liver and heart to get mechanistic insights. KEY FINDINGS Here we show that moderate protein-deficiency malnutrition in weanling rats causes changes in drug disposition in the liver by modification of hepatic ABCC3 and MRP2 transporters through the TNFα signalling axis. Furthermore, malnourished rats in repeat-dose doxorubicin toxicity study showed higher toxicity and mortality. A higher accumulation of doxorubicin in the heart was observed which was associated with alterations in cardiac metabolic pathways and increased cardiotoxicity. SIGNIFICANCE Our findings indicate that moderate malnutrition causes increased susceptibility towards toxic side effects of chemotherapy. These results may necessitate further investigations and new guidelines on the dosing of chemotherapy in moderately malnourished pediatric cancer patients.
Collapse
Affiliation(s)
- Megha Garg
- Department of Clinical Pharmacology, Advanced Centre for Treatment, Research, and Education in Cancer, Kharghar, Navi Mumbai, Maharashtra 410210, India; Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai, Maharashtra 400094, India
| | - Khushboo Gandhi
- Department of Clinical Pharmacology, Advanced Centre for Treatment, Research, and Education in Cancer, Kharghar, Navi Mumbai, Maharashtra 410210, India
| | - Poonam Gera
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai, Maharashtra 400094, India; Biorepository, Advanced Centre for Treatment Research and Education in Cancer, Kharghar, Navi Mumbai, Maharashtra 410210, India
| | - Shraddha Mahesh Jadhav
- Department of Clinical Pharmacology, Advanced Centre for Treatment, Research, and Education in Cancer, Kharghar, Navi Mumbai, Maharashtra 410210, India
| | - Bhabani Mohanty
- Department of Comparative Oncology and Small Animal Imaging Facility, ACTREC, Tata Memorial Center, Kharghar, Navi-Mumbai, Maharashtra 410210, India
| | - Murari Gurjar
- Department of Clinical Pharmacology, Advanced Centre for Treatment, Research, and Education in Cancer, Kharghar, Navi Mumbai, Maharashtra 410210, India; Department of Clinical Pharmacology, Mahamana Pandit Madan Mohan Malviya Cancer Centre, Banaras Hindu University Campus, Varanasi, Uttar Pradesh 221005, India
| | | | - Rajul Gala
- Paediatric Oncology, Tata Memorial Hospital, Mumbai, India
| | - Pradip Chaudhari
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai, Maharashtra 400094, India; Department of Comparative Oncology and Small Animal Imaging Facility, ACTREC, Tata Memorial Center, Kharghar, Navi-Mumbai, Maharashtra 410210, India
| | - Maya Prasad
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai, Maharashtra 400094, India; Paediatric Oncology, Tata Memorial Hospital, Mumbai, India
| | - Girish Chinnaswamy
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai, Maharashtra 400094, India; Paediatric Oncology, Tata Memorial Hospital, Mumbai, India
| | - Vikram Gota
- Department of Clinical Pharmacology, Advanced Centre for Treatment, Research, and Education in Cancer, Kharghar, Navi Mumbai, Maharashtra 410210, India; Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai, Maharashtra 400094, India.
| |
Collapse
|
2
|
Kaida H, Chikugo T, Tanaka H, Ishii K. 18 F-FDG Uptake in Pancreatic AL Amyloidosis Associated With Multiple Myeloma. Clin Nucl Med 2024; 49:781-783. [PMID: 38861377 DOI: 10.1097/rlu.0000000000005296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2024]
Abstract
ABSTRACT A 60-year-old woman underwent whole-body contrast-enhanced CT because multiple myeloma was suspected. The contrast-enhanced CT showed pancreatic enlargement without main pancreatic duct dilatation and increased peripancreatic fat tissue. 18 F-FDG PET/CT demonstrated diffuse uptake in the enlargement of the pancreas, left and right ventricles, and vertebral column. Biopsy and bone marrow aspiration cytology revealed amyloid light-chain amyloidosis associated with multiple myeloma. Chemotherapy was performed; 18 F-FDG uptake in the pancreas then disappeared, and the pancreatic enlargement decreased. When diffuse 18 F-FDG uptake in pancreatic enlargement is observed in multiple myeloma patients, amyloid light-chain amyloidosis should be considered.
Collapse
Affiliation(s)
| | - Takaaki Chikugo
- Departments of Department of Diagnostic Pathology to the Department of Pathology
| | - Hirokazu Tanaka
- Hematology and Rheumatology, Kindai University Faculty of Medicine, Osakasayama City, Osaka, Japan
| | | |
Collapse
|
3
|
Oh EL, Dias P, Al-Ogaili Z, Otto J, Warburton L. Unresectable cardiac metastasis from melanoma responds well to combination immunotherapy-a case report. Eur Heart J Case Rep 2024; 8:ytae262. [PMID: 38868157 PMCID: PMC11167960 DOI: 10.1093/ehjcr/ytae262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 05/09/2024] [Accepted: 05/23/2024] [Indexed: 06/14/2024]
Abstract
Background Melanoma can metastasize to distal organs including the heart although presentation with a symptomatic cardiac metastasis is rare. The optimal management remains uncertain particularly in the era of immunotherapy. Case summary We report a case presenting with a large unresectable cardiac metastasis from melanoma that responded well to treatment with immunotherapy. Conclusion Melanoma can metastasize to the heart and is often challenging to diagnose. Combination immunotherapy can be an effective treatment option even in the setting of a symptomatic and unresectable cardiac metastasis.
Collapse
Affiliation(s)
- Ek Leone Oh
- Medical Oncology Department, Fiona Stanley Hospital, 11 Robin Warren Drive, Murdoch, WA 6150, Australia
| | - Peter Dias
- Cardiology Department, Fiona Stanley Hospital, 11 Robin Warren Drive, Murdoch, WA 6150, Australia
- Advara Heartcare, Wexford Medical Centre, Murdoch, WA 6150, Australia
| | - Zeyad Al-Ogaili
- Nuclear Medicine Department, Fiona Stanley Hospital, 11 Robin Warren Drive, Murdoch, WA 6150, Australia
| | - Jacobus Otto
- Radiology Department, Fiona Stanley Hospital, 11 Robin Warren Drive, Murdoch, WA 6150, Australia
| | - Lydia Warburton
- Medical Oncology Department, Fiona Stanley Hospital, 11 Robin Warren Drive, Murdoch, WA 6150, Australia
- Centre for Precision Health, Edith Cowan University, Joondalup, WA 6027, Australia
| |
Collapse
|
4
|
Singh P, Parida GK, Singhal T, Gupta J, Agrawal K. Incidental Detection of Myocardial Ischemia on Whole-Body PET/CT in a Patient With Carcinoma Lung. Clin Nucl Med 2024; 49:e156-e157. [PMID: 38377353 DOI: 10.1097/rlu.0000000000005082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
ABSTRACT 18 F-FDG PET/CT being a whole-body technique can detect multiple other critical nononcological findings. Various cardiac disorders identified incidentally on 18 F-FDG have been reported to help in timely management and improve overall patient care. We hereby present one such case where 18 F-FDG PET/CT performed for a workup of carcinoma lung revealed abnormal myocardial FDG uptake in the anteroseptal and apical region, which raised suspicion of myocardial ischemia such as hot spot imaging. On coronary angiography, coronary artery disease was detected and subsequently managed.
Collapse
Affiliation(s)
| | | | | | - Jaydeep Gupta
- Cardiology, All India Institute of Medical Sciences, Bhubaneswar, India
| | | |
Collapse
|
5
|
Moscatelli S, Leo I, Bianco F, Surkova E, Pezel T, Donald NA, Triumbari EKA, Bassareo PP, Pradhan A, Cimini A, Perrone MA. The Role of Multimodality Imaging in Patients with Congenital Heart Disease and Infective Endocarditis. Diagnostics (Basel) 2023; 13:3638. [PMID: 38132222 PMCID: PMC10742664 DOI: 10.3390/diagnostics13243638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 12/02/2023] [Accepted: 12/09/2023] [Indexed: 12/23/2023] Open
Abstract
Infective endocarditis (IE) represents an important medical challenge, particularly in patients with congenital heart diseases (CHD). Its early and accurate diagnosis is crucial for effective management to improve patient outcomes. Multimodality imaging is emerging as a powerful tool in the diagnosis and management of IE in CHD patients, offering a comprehensive and integrated approach that enhances diagnostic accuracy and guides therapeutic strategies. This review illustrates the utilities of each single multimodality imaging, including transthoracic and transoesophageal echocardiography, cardiac computed tomography (CCT), cardiovascular magnetic resonance imaging (CMR), and nuclear imaging modalities, in the diagnosis of IE in CHD patients. These imaging techniques provide crucial information about valvular and intracardiac structures, vegetation size and location, abscess formation, and associated complications, helping clinicians make timely and informed decisions. However, each one does have limitations that influence its applicability.
Collapse
Affiliation(s)
- Sara Moscatelli
- Inherited Cardiovascular Diseases, Great Ormond Street Hospital, Children NHS Foundation Trust, London WC1N 3JH, UK; (S.M.); (N.A.D.)
- Institute of Cardiovascular Sciences, University College London, London WC1E 6BT, UK
| | - Isabella Leo
- Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy;
- CMR Unit, Cardiology Department, Royal Brompton and Harefield Hospitals, Guys’ and St Thomas’ NHS Trust, London SW3 5NP, UK
| | - Francesco Bianco
- Cardiovascular Sciences Department, AOU “Ospedali Riuniti”, 60126 Ancona, Italy;
| | - Elena Surkova
- Department of Echocardiography, Royal Brompton and Harefield Hospitals, Guy’s and St Thomas’ NHS Foundation Trust, London SW3 5NP, UK;
| | - Théo Pezel
- Département de Cardiologie, Université Paris-Cité, Hôpital Universitaire de Lariboisière, Assistance Publique des Hôpitaux de Paris (APHP), Inserm UMRS 942, 75010 Paris, France;
| | - Natasha Alexandra Donald
- Inherited Cardiovascular Diseases, Great Ormond Street Hospital, Children NHS Foundation Trust, London WC1N 3JH, UK; (S.M.); (N.A.D.)
| | | | - Pier Paolo Bassareo
- School of Medicine, University College of Dublin, Mater Misericordiae University Hospital, Children’s Health Ireland Crumlin, D07 R2WY Dublin, Ireland;
| | - Akshyaya Pradhan
- Department of Cardiology, King George’s Medical University, Lucknow 226003, India;
| | - Andrea Cimini
- Nuclear Medicine Unit, St. Salvatore Hospital, 67100 L’Aquila, Italy
| | - Marco Alfonso Perrone
- Division of Cardiology and CardioLab, Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
- Clinical Pathways and Epidemiology Unit, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy
| |
Collapse
|
6
|
Donadoni M, Petullà M, Del Medico M, Barosi A, Wu MA. A rare presentation of heart failure with preserved ejection fraction. Intern Emerg Med 2023; 18:2339-2345. [PMID: 37148407 DOI: 10.1007/s11739-023-03296-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 04/26/2023] [Indexed: 05/08/2023]
Affiliation(s)
- Mattia Donadoni
- Division of Internal Medicine, Department of Biomedical and Clinical Sciences, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, University of Milan, Milan, Italy
| | - Marina Petullà
- Department of Radiology, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, University of Milan, Milan, Italy
| | - Marta Del Medico
- Division of Internal Medicine, Department of Biomedical and Clinical Sciences, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, University of Milan, Milan, Italy
| | - Alberto Barosi
- Division of Cardiology, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, University of Milan, Milan, Italy
| | - Maddalena Alessandra Wu
- Division of Internal Medicine, Department of Biomedical and Clinical Sciences, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, University of Milan, Milan, Italy.
| |
Collapse
|
7
|
Plata-Corona JC, González-Ortiz A, García-Cárdenas M, Espinola-Zavaleta N, Alexanderson-Rosas E, Carvajal-Juárez I. Role of molecular imaging in the diagnosis of prosthetic aortic valve endocarditis by Bacillus licheniformis: a case report. Eur Heart J Case Rep 2023; 7:ytad425. [PMID: 38426048 PMCID: PMC10903176 DOI: 10.1093/ehjcr/ytad425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 08/09/2023] [Accepted: 08/30/2023] [Indexed: 03/02/2024]
Abstract
Background Infective endocarditis is a challenging diagnosis that usually requires cardiovascular image confirmation as part of the approach. 18F-Fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) is an imaging technique more sensible for the diagnosis of prosthetic valve endocarditis (PVE) when echocardiography is inconclusive. Case summary We present the case of a 35-year-old man who had a previous Bentall-De Bono procedure 4 years prior that included biological, national institute of cardiology (INC)-type, locally manufactured aortic valve replacement and woven Dacron tube graft implantation in the ascending aorta. He was admitted because of dyspnoea, oedema, fever, and syncope. A complete auriculoventricular blockade was diagnosed, requiring cardiac pacing. Also, infective endocarditis (IE) was suspected. Blood cultures showed the isolation of Bacillus licheniformis. Transthoracic echocardiography, transoesophageal echocardiography, and CT angiography were inconclusive for IE. Treatment was initiated with intravenous (IV) antibiotic therapy, and an extensive protocol for IE, including molecular imaging modalities, was ordered. 99mTc-Ubiquicidin scintigraphy was acquired without abnormal findings. Images of 18F-FDG-PET/CT revealed abnormally intense heterogeneous uptake in the prosthetic aortic annulus in a classic pattern. Applying the modified 2015 Duke criteria for PET/CT, PVE was confirmed. Discussion Although the other imaging modalities were negative, the high clinical suspicion made it mandatory to continue the study protocol, remarking on the utility of 18F-FDG-PET/CT on patients categorized as having 'possible' endocarditis, as in our patient.
Collapse
Affiliation(s)
| | - Araceli González-Ortiz
- Clinical Cardiology, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico
| | - Mauricio García-Cárdenas
- Nuclear Cardiology Department, National Institute of Cardiology Ignacio Chavez, Juan Badiano No 1, Colonia Sección XVI, Tlalpan, Mexico City, P.C. 14080, Mexico
| | - Nilda Espinola-Zavaleta
- Nuclear Cardiology Department, National Institute of Cardiology Ignacio Chavez, Juan Badiano No 1, Colonia Sección XVI, Tlalpan, Mexico City, P.C. 14080, Mexico
- Echocardiography Department, ABC Medical Center, I.A.P., Mexico City, Mexico
| | - Erick Alexanderson-Rosas
- Nuclear Cardiology Department, National Institute of Cardiology Ignacio Chavez, Juan Badiano No 1, Colonia Sección XVI, Tlalpan, Mexico City, P.C. 14080, Mexico
- PET/CT Unit, Autonomous National University of Mexico (UNAM), Mexico City, Mexico
- Department of Physiology, Faculty of Medicine, Autonomous National University of Mexico (UNAM), Mexico City, Mexico
| | - Isabel Carvajal-Juárez
- Nuclear Cardiology Department, National Institute of Cardiology Ignacio Chavez, Juan Badiano No 1, Colonia Sección XVI, Tlalpan, Mexico City, P.C. 14080, Mexico
| |
Collapse
|
8
|
Hirata K, Kamagata K, Ueda D, Yanagawa M, Kawamura M, Nakaura T, Ito R, Tatsugami F, Matsui Y, Yamada A, Fushimi Y, Nozaki T, Fujita S, Fujioka T, Tsuboyama T, Fujima N, Naganawa S. From FDG and beyond: the evolving potential of nuclear medicine. Ann Nucl Med 2023; 37:583-595. [PMID: 37749301 DOI: 10.1007/s12149-023-01865-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 09/09/2023] [Indexed: 09/27/2023]
Abstract
The radiopharmaceutical 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG) has been dominantly used in positron emission tomography (PET) scans for over 20 years, and due to its vast utility its applications have expanded and are continuing to expand into oncology, neurology, cardiology, and infectious/inflammatory diseases. More recently, the addition of artificial intelligence (AI) has enhanced nuclear medicine diagnosis and imaging with FDG-PET, and new radiopharmaceuticals such as prostate-specific membrane antigen (PSMA) and fibroblast activation protein inhibitor (FAPI) have emerged. Nuclear medicine therapy using agents such as [177Lu]-dotatate surpasses conventional treatments in terms of efficacy and side effects. This article reviews recently established evidence of FDG and non-FDG drugs and anticipates the future trajectory of nuclear medicine.
Collapse
Affiliation(s)
- Kenji Hirata
- Department of Diagnostic Imaging, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan.
| | - Koji Kamagata
- Department of Radiology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Daiju Ueda
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
| | - Masahiro Yanagawa
- Department of Radiology, Osaka University Graduate School of Medicine, Suita, Osaka, 565-0871, Japan
| | - Mariko Kawamura
- Department of Radiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Takeshi Nakaura
- Department of Diagnostic Radiology, Kumamoto University Graduate School of Medicine, 1-1-1 Honjo Chuo-ku, Kumamoto, 860-8556, Japan
| | - Rintaro Ito
- Department of Radiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Fuminari Tatsugami
- Department of Diagnostic Radiology, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Yusuke Matsui
- Department of Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Akira Yamada
- Department of Radiology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-2621, Japan
| | - Yasutaka Fushimi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Taiki Nozaki
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-0016, Japan
| | - Shohei Fujita
- Department of Radiology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Tomoyuki Fujioka
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Takahiro Tsuboyama
- Department of Radiology, Osaka University Graduate School of Medicine, Suita, Osaka, 565-0871, Japan
| | - Noriyuki Fujima
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, N15, W5, Kita-ku, Sapporo, 060-8638, Japan
| | - Shinji Naganawa
- Department of Radiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| |
Collapse
|
9
|
Zhao L, Pang Y, Sun L, Lin Q, Chen H. Extranodal Rosai-Dorfman disease involving pulmonary artery detected by 68Ga-FAPI PET/CT and fused 68Ga-FAPI PET/MRI. Eur J Nucl Med Mol Imaging 2023; 50:2565-2566. [PMID: 36853563 DOI: 10.1007/s00259-023-06167-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 02/18/2023] [Indexed: 03/01/2023]
Affiliation(s)
- Liang Zhao
- Department of Nuclear Medicine & Minnan PET Center, Xiamen Cancer Center, The First Affiliated Hospital of Xiamen University, School of Medicine, Teaching Hospital of Fujian Medical University, Xiamen, China
- Departments of Diagnostic Radiology, Surgery, Chemical and Biomolecular Engineering, and Biomedical Engineering, Yong Loo Lin School of Medicine and Faculty of Engineering, National University of Singapore, Singapore, Singapore
- Department of Radiation Oncology, Xiamen Cancer Center, The First Affiliated Hospital of Xiamen University, School of Medicine, Teaching Hospital of Fujian Medical University, Xiamen, China
| | - Yizhen Pang
- Department of Nuclear Medicine & Minnan PET Center, Xiamen Cancer Center, The First Affiliated Hospital of Xiamen University, School of Medicine, Teaching Hospital of Fujian Medical University, Xiamen, China
- Department of Radiation Oncology, Xiamen Cancer Center, The First Affiliated Hospital of Xiamen University, School of Medicine, Teaching Hospital of Fujian Medical University, Xiamen, China
| | - Long Sun
- Department of Nuclear Medicine & Minnan PET Center, Xiamen Cancer Center, The First Affiliated Hospital of Xiamen University, School of Medicine, Teaching Hospital of Fujian Medical University, Xiamen, China
| | - Qin Lin
- Department of Radiation Oncology, Xiamen Cancer Center, The First Affiliated Hospital of Xiamen University, School of Medicine, Teaching Hospital of Fujian Medical University, Xiamen, China
| | - Haojun Chen
- Department of Nuclear Medicine & Minnan PET Center, Xiamen Cancer Center, The First Affiliated Hospital of Xiamen University, School of Medicine, Teaching Hospital of Fujian Medical University, Xiamen, China.
| |
Collapse
|
10
|
Manabe O, Tsukui T, Yoshimura K, Oshiro H, Oyama-Manabe N, Aikawa T, Takahashi K, Sakakura K, Fujita H. 18F-FDG PET/CT findings in autopsy confirmed a case of ischemic cardiac disease at an early stage. Eur J Nucl Med Mol Imaging 2023; 50:2224-2225. [PMID: 36690881 DOI: 10.1007/s00259-023-06116-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 01/11/2023] [Indexed: 01/25/2023]
Affiliation(s)
- Osamu Manabe
- Department of Radiology, Jichi Medical University Saitama Medical Center, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Takunori Tsukui
- Department of Cardiovascular Medicine, Jichi Medical University Saitama Medical Center, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Kazuki Yoshimura
- Division of Hematology, Jichi Medical University Saitama Medical Center, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Hisashi Oshiro
- Department of Pathology, Jichi Medical University Saitama Medical Center, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Noriko Oyama-Manabe
- Department of Radiology, Jichi Medical University Saitama Medical Center, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan.
| | - Tadao Aikawa
- Department of Radiology, Jichi Medical University Saitama Medical Center, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Keiko Takahashi
- Department of Radiology, Jichi Medical University Saitama Medical Center, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Kenichi Sakakura
- Department of Cardiovascular Medicine, Jichi Medical University Saitama Medical Center, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| | - Hideo Fujita
- Department of Cardiovascular Medicine, Jichi Medical University Saitama Medical Center, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan
| |
Collapse
|
11
|
Becker MMC, Arruda GFA, Berenguer DRF, Buril RO, Cardinale D, Brandão SCS. Anthracycline cardiotoxicity: current methods of diagnosis and possible role of 18F-FDG PET/CT as a new biomarker. CARDIO-ONCOLOGY (LONDON, ENGLAND) 2023; 9:17. [PMID: 36973762 PMCID: PMC10041777 DOI: 10.1186/s40959-023-00161-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 02/01/2023] [Indexed: 03/29/2023]
Abstract
Despite advances in chemotherapy, the drugs used in cancer treatment remain rather harmful to the cardiovascular system, causing structural and functional cardiotoxic changes. Positron-emission tomography associated with computed tomography (PET/CT) has emerged like a promising technique in the early diagnosis of these adverse drug effects as the myocardial tissue uptake of fluorodeoxyglucose labeled with fluorine-18 (18F-FDG), a glucose analog, is increased after their use. Among these drugs, anthracyclines are the most frequently associated with cardiotoxicity because they promote heart damage through DNA breaks, and induction of an oxidative, proinflammatory, and toxic environment. This review aimed to present the scientific evidence available so far regarding the use of 18F-FDG PET/CT as an early biomarker of anthracycline-related cardiotoxicity. Thus, it discusses the physiological basis for its uptake, hypotheses to justify its increase in the myocardium affected by anthracyclines, importance of 18F-FDG PET/CT findings for cardio-oncology, and primary challenges of incorporating this technique in standard clinical oncology practice.
Collapse
Affiliation(s)
- Mônica M C Becker
- Postgraduate Program in Surgery, Federal University of Pernambuco, Recife, State of Pernambuco, Brazil
| | - Gustavo F A Arruda
- Recife Medical School, Federal University of Pernambuco, Recife, State of Pernambuco, Brazil
| | - Diego R F Berenguer
- Postgraduate Program in Translational Health, Federal University of Pernambuco, Recife, State of Pernambuco, Brazil
| | - Roberto O Buril
- Postgraduate Program in Surgery, Federal University of Pernambuco, Recife, State of Pernambuco, Brazil
| | - Daniela Cardinale
- Cardioncology Unit, European Institute of Oncology, I.R.C.C.S., Milan, Italy
| | - Simone C S Brandão
- Postgraduate Program in Surgery, Federal University of Pernambuco, Recife, State of Pernambuco, Brazil.
- Recife Medical School, Federal University of Pernambuco, Recife, State of Pernambuco, Brazil.
- Nuclear Medicine Department, Hospital das Clínicas, Federal University of Pernambuco, 1st floor, 1235 Avenida Professor Moraes Rego, Recife, State of Pernambuco, 50670-901, Brazil.
| |
Collapse
|
12
|
Rojulpote C, Patil S, Vidula MK, Kotloff R, Prenner S, Bravo PE. Persistent FDG Uptake at Apical Aneurysm in a Patient With Cardiac Sarcoidosis. JACC: CASE REPORTS 2023; 10:101763. [PMID: 36974049 PMCID: PMC10039390 DOI: 10.1016/j.jaccas.2023.101763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 01/13/2023] [Indexed: 03/17/2023]
Abstract
We present a case of cardiac sarcoidosis with persistent, focal fluorodeoxyglucose uptake at the left ventricular apical aneurysm concerning for ongoing active inflammatory injury, prompting aggressive immunosuppressive therapy. This case highlights the importance of understanding the various clinical entities that may resemble disease activity on fluorodeoxyglucose positron emission tomography/computed tomography imaging. (Level of Difficulty: Intermediate.).
Collapse
|
13
|
FDG-PET findings associated with various medical procedures and treatments. Jpn J Radiol 2022; 41:459-476. [PMID: 36575286 PMCID: PMC9794480 DOI: 10.1007/s11604-022-01376-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 12/12/2022] [Indexed: 12/29/2022]
Abstract
[18F]-fluorodeoxyglucose (FDG) positron emission tomography (PET) is a well-established modality with high sensitivity for the diagnosis and staging of oncologic patients. FDG is taken up by the glucose transporter of the cell membrane and becomes trapped within the cell. In addition to malignant neoplasms, active inflammatory lesions and some kinds of benign tumors also accumulate FDG. Moreover, the degree of uptake into normal organs and tissues depends on various physiological conditions, which is affected by various medical procedures, treatments, and drugs. To avoid misleading interpretations, it is important to recognize possible situations of unexpected abnormal accumulation that mimic tumor lesions. In this review, we present various FDG findings associated with surgical or medical procedures and treatments. Some findings reflect the expected physiological reaction to treatment, and some show inflammation due to prior procedures. Occasionally, FDG-PET visualizes other disorders that are unrelated to the malignancy, which may be associated with the adverse effects of certain drugs that the patient is taking. Careful review of medical records and detailed interviews of patients are thus necessary.
Collapse
|
14
|
Recent Advances in Cardiovascular Diseases Research Using Animal Models and PET Radioisotope Tracers. Int J Mol Sci 2022; 24:ijms24010353. [PMID: 36613797 PMCID: PMC9820417 DOI: 10.3390/ijms24010353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 12/28/2022] Open
Abstract
Cardiovascular diseases (CVD) is a collective term describing a range of conditions that affect the heart and blood vessels. Due to the varied nature of the disorders, distinguishing between their causes and monitoring their progress is crucial for finding an effective treatment. Molecular imaging enables non-invasive visualisation and quantification of biological pathways, even at the molecular and subcellular levels, what is essential for understanding the causes and development of CVD. Positron emission tomography imaging is so far recognized as the best method for in vivo studies of the CVD related phenomena. The imaging is based on the use of radioisotope-labelled markers, which have been successfully used in both pre-clinical research and clinical studies. Current research on CVD with the use of such radioconjugates constantly increases our knowledge and understanding of the causes, and brings us closer to effective monitoring and treatment. This review outlines recent advances in the use of the so-far available radioisotope markers in the research on cardiovascular diseases in rodent models, points out the problems and provides a perspective for future applications of PET imaging in CVD studies.
Collapse
|
15
|
Moreno-Ballesteros A, Lojo-Ramírez JA, Jiménez-Hoyuela-García JM. 18F-FDG PET/CT focal cardiac uptake: An unsuspected Chiari's network. J Nucl Cardiol 2022; 29:3570-3571. [PMID: 33851356 DOI: 10.1007/s12350-021-02605-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 03/02/2021] [Indexed: 01/18/2023]
Affiliation(s)
- Ana Moreno-Ballesteros
- Unidad de Gestión Clínica de Medicina Nuclear, Hospital Universitario Virgen Macarena, Avenida Dr fedriani nº3, 41009, Seville, Spain.
| | - Jose Antonio Lojo-Ramírez
- Unidad de Gestión Clínica de Medicina Nuclear, Hospital Universitario Virgen del Rocío, Avda de Manuel Siurot s/n, 41013, Seville, Spain
| | - Jose Manuel Jiménez-Hoyuela-García
- Unidad de Gestión Clínica de Medicina Nuclear, Hospital Universitario Virgen del Rocío, Avda de Manuel Siurot s/n, 41013, Seville, Spain
| |
Collapse
|
16
|
Vehof V, Büther F, Florian A, Drakos S, Chamling B, Kies P, Stegger L, Yilmaz A. Hybrid CMR- and FDG-PET-Imaging Gives New Insights Into the Relationship of Myocardial Metabolic Activity and Fibrosis in Patients With Becker Muscular Dystrophy. Front Cardiovasc Med 2022; 9:793972. [PMID: 35174232 PMCID: PMC8841800 DOI: 10.3389/fcvm.2022.793972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 01/12/2022] [Indexed: 11/29/2022] Open
Abstract
Background Cardiac involvement in patients with Becker muscular dystrophy (BMD) is an important predictor of mortality. The cardiac phenotype of BMD patients is characterized by slowly progressive myocardial fibrosis that starts in the left ventricular (LV) free wall segments and extends into the septal wall during the disease course. Purpose Since the reason for this characteristic cardiac phenotype is unknown and comprehensive approaches using e.g. hybrid imaging combining cardiovascular magnetic resonance (CMR) with 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) are limited, the present study addressed this issue by a comprehensive non-invasive imaging approach. Methods Hybrid CMR- and FDG-PET-imaging was performed in N = 14 patients with BMD on a whole-body Biograph mMR system (Siemens, Erlangen, Germany). The CMR protocol comprised cine- and late-gadolinium-enhancement (LGE)-imaging. Metabolism was assessed with FDG-PET after oral glucose loading to effect myocardial carbohydrate uptake. PET was acquired for 65 min starting with tracer injection. Uptake values from 60 to 65 min p.i. were divided by the area under the blood activity curve and reported as percentages relative to the segment with maximal myocardial FDG uptake. Results A characteristic pattern of LGE in the LV lateral wall was observed in 13/14 patients whereas an additional septal LGE pattern was documented in 6/14 patients only. There was one patient without any LGE. Segmental FDG uptake was 88 ± 6% in the LV lateral wall vs. 77 ± 10% in the septal wall (p < 0.001). There was an inverse relationship between segmental FDG activity compared to segmental LGE extent (r = −0.33, p = 0.089). There were N = 6 LGE-positive patients with a segmental difference in FDG uptake of >15% in the LV lateral wall compared to the septal wall = ΔFDG-high group (lateral FDG = 91±3% vs. septal FDG = 69±8%; p < 0.001) while the remaining N = 7 LGE-positive patients showed a segmental difference in FDG uptake of ≤ 15% = ΔFDG-low group (lateral FDG = 85±7% vs. septal FDG = 83 ± 5%; p = 0.37). Patients in the ΔFDG-high group showed only a minor difference in the LGE extent between the LV lateral wall vs. septal wall (p = 0.09) whereas large differences were observed in the ΔFDG-low group (p < 0.004). Conclusions Segmental FDG uptake—reflecting myocardial metabolic activity—is higher in the LV free wall of BMD patients—possibly due to a higher segmental work load. However, segmental metabolic activity seems to be dependent on and limited by the respective segmental extent of myocardial fibrosis as depicted by LGE-imaging.
Collapse
Affiliation(s)
- Volker Vehof
- Department of Cardiology I, University Hospital Münster, Münster, Germany
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
| | - Florian Büther
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
| | - Anca Florian
- Department of Cardiology I, University Hospital Münster, Münster, Germany
| | - Stefanos Drakos
- Department of Cardiology I, University Hospital Münster, Münster, Germany
| | - Bishwas Chamling
- Department of Cardiology I, University Hospital Münster, Münster, Germany
| | - Peter Kies
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
| | - Lars Stegger
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
| | - Ali Yilmaz
- Department of Cardiology I, University Hospital Münster, Münster, Germany
- *Correspondence: Ali Yilmaz
| |
Collapse
|
17
|
Imaging Inflammation in Patients and Animals: Focus on PET Imaging the Vulnerable Plaque. Cells 2021; 10:cells10102573. [PMID: 34685553 PMCID: PMC8533866 DOI: 10.3390/cells10102573] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 09/18/2021] [Accepted: 09/23/2021] [Indexed: 02/07/2023] Open
Abstract
Acute coronary syndrome (ACS) describes a range of conditions associated with the rupture of high-risk or vulnerable plaque. Vulnerable atherosclerotic plaque is associated with many changes in its microenvironment which could potentially cause rapid plaque progression. Present-day PET imaging presents a plethora of radiopharmaceuticals designed to image different characteristics throughout plaque progression. Improved knowledge of atherosclerotic disease pathways has facilitated a growing number of pathophysiological targets for more innovative radiotracer design aimed at identifying at-risk vulnerable plaque and earlier intervention opportunity. This paper reviews the efficacy of PET imaging radiotracers 18F-FDG, 18F-NaF, 68Ga-DOTATATE, 64Cu-DOTATATE and 68Ga-pentixafor in plaque characterisation and risk assessment, as well as the translational potential of novel radiotracers in animal studies. Finally, we discuss our murine PET imaging experience and the challenges encountered.
Collapse
|
18
|
Manabe O, Tamaki N. The future of cardiac disease assessment using 18F-FDG PET/CT. Jpn J Radiol 2021; 39:511-513. [PMID: 33893575 DOI: 10.1007/s11604-021-01114-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Osamu Manabe
- Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Nagara Tamaki
- Department of Radiology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
| |
Collapse
|