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Quantitative assessment of early changes in myocardial extracellular volume during postoperative adjuvant chemotherapy in patients with breast cancer via dual-layer spectral detector computed tomography: a cohort study

Year: 2024

Type: article

Abstract: Background: The major of anticancer therapies induce a wide spectrum of cardiotoxic effects. Early identification of anticancer treatment-associated cardiotoxicity is critical to informing decisions on subsequent interventions. Myocardial extracellular volume (ECV) has been proposed as a useful parameter for quantifying the early cardiotoxicity of cancer-related treatment. This study used dual-layer spectral detector computed tomography (CT) technology to simultaneously assess cardiac function and myocardial ECV, characterizing the early changes in parameters during breast cancer therapy. Methods: A single-center cohort study was conducted that prospectively enrolled 40 women with breast cancer (mean age 47.5±10.8 years) who underwent postoperative adjuvant chemotherapy between January 12, 2022, and November 2, 2023, with available data from baseline to 3 months after chemotherapy of cardiac computed tomography (CCT), ultrasound cardiography (UCG), electrocardiography, and serum biomarkers. Midventricular and global ECVs of the left ventricle were measured based on an iodine map of the late enhancement phase of dual-layer spectral detector CT. Changes in cardiac function parameters, ECVs, and cardiac biomarkers from baseline to the 3-month follow-up were analyzed. Correlation coefficients between the changes in cardiac function parameters and ECVs were calculated. Results: . 27.3%±2.7%; P<0.01). Although changes in ECVs were not associated with changes in LVEFs, global ECV changes were moderately correlated with changes in left ventricular end-diastolic volume/BSA ratio (CCT-LVEDV indexed) (r=0.52; P<0.001), left ventricular stroke volume/BSA ratio (CCT-LVSV indexed) (r=0.56; P<0.001), CCT-CO indexed (r=0.40; P=0.01), and LVEFV indexed (r=0.41; P=0.009). Conclusions: CCT-derived ECV was used to evaluate myocardial changes in the early stage of chemotherapy before LVEF significantly decreased. The increases in ECV were not correlated with LVEF. The changes in myocardial ECVs were moderately correlated with cardiac function parameters. ECV may be a useful biomarker for detecting cardiotoxicity in patients with breast cancer in the early stage of anticancer therapy.

Source: Quantitative Imaging in Medicine and Surgery

DOI: 10.21037/qims-24-777