Doxorubicin-induced cardiac toxicity and cardiac rest gated blood pool imaging.
Anthracyclines are one of the most commonly used and potent chemotherapeutic agents. Doxorubicin (Adriamycin) is one common anthracycline used to treat many solid tumors including breast, sarcomas, gynecologic and hematological malignancies, such as leukemias and lymphomas. However, its use is often limited due to dose-dependent cardiotoxicity. As a result, patients receiving doxorubicin should have close monitoring of their left ventricular function. The gated cardiac blood pool (GBP) study is one of the most accurate and reproducible methods of assessing left ventricular function. This report presents an overview of (1) the incidence, clinical course, mechanisms, pathology, prevention, and monitoring of doxorubicin-induced cardiotoxicity (DIC), (2) the use of GBP studies in monitoring for DIC, and (3) 2 algorithms for the use of GBP studies in monitoring for DIC. This report concludes with a proposed algorithm for the use of GBP studies in DIC. With an understanding of DIC, GBP studies, and various algorithms, the interpreting physician may help the oncologist identify DIC earlier, more accurately, and before it becomes clinically apparent.
Division of Nuclear Medicine, Department of Medicine, Washington Hospital Center, Washington, DC 20010, USA.
Marta J
MJ
Aiken
Vijay
V
Suhag
Carlos A
CA
Garcia
Elmo
E
Acio
Shari
S
Moreau
Dennis A
DA
Priebat
Shyam P
SP
Chennupati
Douglas
D
Van Nostrand
D004317:Doxorubicin / Q000009:adverse effects*; D015637:Gated Blood-Pool Imaging / Q000379:methods*; D006331:Heart Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D012146:Rest / Q000502:physiology*
D004317:Doxorubicin