title: A prospective comparison of cardiac magnetic resonance imaging and radionuclide ventriculography in the assessment of cardiac function in patients treated with anthracycline-based chemotherapy.
abstract: OBJECTIVE
  To compare cardiac MRI and radionuclide ventriculography (RVG) in cardiac monitoring during anthracycline (doxorubicin)-based chemotherapy.
  
  
  METHODS
  We studied 10 previously untreated adult non-Hodgkin lymphoma patients. Left ventricular ejection fraction (LVEF) was assessed by MRI and RVG simultaneously. In addition, left ventricular (LV) and left atrial size were determined by MRI. Both MRI and RVG measurements were determined at baseline and then repeated after eight cycles of CHOP chemotherapy (cumulative doxorubicin dose of 400 mg/m²). Power calculations were made on the basis of reproducibility measurements.
  
  
  RESULTS
  Clinical heart failure was not observed in any patient during the study. MRI detected a statistically significant increase in LV end-diastolic volume (128 ± 39 vs. 151 ± 46 ml, P<0.05) and LV mass (119 ± 32 vs. 146 ± 49 g, P<0.05) after doxorubicin therapy but no change in LVEF (46 ± 8 vs. 47 ± 11%, P=NS) or left atrial area. A significant LVEF reduction compared with baseline was observed by RVG (61 ± 10 vs. 50 ± 6%, P<0.01). On average, MRI resulted in 7 ± 10% lower LVEF values compared with RVG.
  
  
  CONCLUSIONS
  RVG seems to be a valuable and repeatable tool in detecting early, subclinical deterioration in cardiac function and is the method of choice in the follow-up of LV function during anthracycline-based chemotherapy. Whether LV volumetric and mass changes found in MRI could predict later significant permanent cardiac damage should be evaluated in larger studies with long-term follow-up.
authors: Department of Radiology, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland. petri.sipola@kuh.fi
authors: Petri
authors: P
authors: Sipola
authors: Sipola
authors: S
authors: Petri
authors: Esko
authors: E
authors: Vanninen
authors: Vanninen
authors: V
authors: Esko
authors: Esa
authors: E
authors: Jantunen
authors: Jantunen
authors: J
authors: Esa
authors: Tapio
authors: T
authors: Nousiainen
authors: Nousiainen
authors: N
authors: Tapio
authors: Mikko
authors: M
authors: Kiviniemi
authors: Kiviniemi
authors: K
authors: Mikko
authors: Juha
authors: J
authors: Hartikainen
authors: Hartikainen
authors: H
authors: Juha
authors: Taru
authors: T
authors: Kuittinen
authors: Kuittinen
authors: K
authors: Taru
mesh_terms: D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects / Q000627:therapeutic use*; D004317:Doxorubicin / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000139:chemically induced / Q000000981:diagnostic imaging*; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy*; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015635:Radionuclide Ventriculography; D015203:Reproducibility of Results; D013318:Stroke Volume / Q000187:drug effects / Q000502:physiology*; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000187:drug effects / Q000502:physiology*
chemical_list: D000903:Antibiotics, Antineoplastic; D004317:Doxorubicin