Detection of doxorubicin cardiotoxicity by using iodine-123 BMIPP early dynamic SPECT: Quantitative evaluation of early abnormality of fatty acid metabolism with the Rutland method

Kimimasa Saito, Kan Takeda, Shinya Okamoto, Ryuzi Okamoto, Katutoshi Makino, Yukihito Tameda, Yoshiyuki Nomura, Hisato Maeda, Takashi Ichihara, Takeshi Nakano

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20 Citations (Scopus)

Abstract

Background. To evaluate the possibility of predicting the development of doxorubicin-induced cardiomyopathy, we performed quantitative assessment of the early kinetics of iodine-123 betamethyl-iodophenyl-pentadecanoic acid (I-123 BMIPP) by means of dynamic myocardial SPECT. Methods. Thirty-six patients with various malignancies were examined. I-123 BMIPP dynamic myocardial SPECT was performed before chemotherapy, after chemotherapy, or both. Immediately after the injection of I-123 BMIPP (111 MBq), 30-second dynamic SPECT data were acquired successively for 15 minutes. The left ventricular (LV) myocardium was divided into 8 segments in short-axial and vertical slices. By using the time-activity curve (TAC) of each myocardial segment [Mo(t)] as an output function and the TAC of the LV cavity [B(t)] as an input function, the Rutland equation, Mo(t)/B(t)= F + K ∫B(t)dt/B(t), was used as means of assessing all segments. Results. Mo(t)/B(t) showed a good linear correlation with ∫B(t)dt/B(t) from 30 seconds to 4 minutes in all 456 segments. The mean K value of 8 LV segments was significantly lower after chemotherapy than before chemotherapy (0.071 ± 0.019 [n = 21] vs 0.095 ± 0.025 [n = 36], P< .001). In 21 patients in whom dynamic SPECT was performed both before and after chemotherapy, the mean K values of left ventricle showed a significant decrease, from 0.101 ± 0.024 to 0.071 ± 0.019 (P <.0001). The fractional change in the value of K after chemotherapy showed a significant linear correlation with the administered dose of doxorubicin (r = 0.648, P <.002). Conclusion. I-123 BMIPP dynamic myocardial SPECT may be clinically useful, because it permits the early detection of doxorubicin-induced cardiomyopathy.

Original languageEnglish
Pages (from-to)553-561
Number of pages9
JournalJournal of Nuclear Cardiology
Volume7
Issue number6
DOIs
Publication statusPublished - 11-2000
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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