Cardiovascular calcifications after radiation therapy for Hodgkin lymphoma: computed tomography detection and clinical correlation.
OBJECTIVE
To study cardiovascular calcifications, detected by computed tomography, in patients following mediastinal radiation for Hodgkin lymphoma, and correlate them with clinical findings.


METHODS
Fifteen patients, <or=55 years, with computed tomography detected cardiovascular calcifications after mediastinal radiotherapy for Hodgkin lymphoma were identified during a 10-year period. Calcifications were evaluated for site and extent and were correlated with clinical data including symptoms and signs of heart disease, angiographic and surgical findings.


RESULTS
Accelerated calcifications were detected in the coronary arteries (n=11), in the aorta (n=11), and in the aortic valve and the mitral apparatus (n=8). Calcifications were more extensive when radiation was given at a young age. Clinical evidence of cardiovascular disease included coronary events in three patients, valvular dysfunction in two, pericarditis in two and complete atrioventricular block in one. Seven patients had no cardiac symptoms.


CONCLUSIONS
Early cardiovascular calcifications can be radiation associated. Such calcifications may represent radiation-induced atherosclerosis and can be detected by computed tomography even in asymptomatic patients. The implication of our findings is that spiral computed tomography may serve as a non-invasive modality to detect accelerated cardiovascular calcifications in high-risk asymptomatic patients who survived Hodgkin lymphoma.
Department of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, Israel. apter@post.tau.ac.il
Sara
S
Apter
Joseph
J
Shemesh
Pia
P
Raanani
Orith
O
Portnoy
Michael
M
Thaler
Rivka
R
Zissin
David
D
Ezra
Judith
J
Rozenman
Raphael
R
Pfeffer
Marjorie
M
Hertz
D000328:Adult; D001011:Aorta / Q000473:pathology; D002114:Calcinosis / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D009202:Cardiomyopathies / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D003327:Coronary Disease / Q000473:pathology; D003331:Coronary Vessels / Q000473:pathology; D005260:Female; D006351:Heart Valves / Q000473:pathology; D006689:Hodgkin Disease / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008477:Mediastinal Diseases / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D008875:Middle Aged; D011832:Radiation Injuries / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D011878:Radiotherapy / Q000009:adverse effects; D014057:Tomography, X-Ray Computed