title: Relationship of promising methods in the detection of anthracycline-induced cardiotoxicity in breast cancer patients.
abstract: OBJECTIVE
  It remains challenging to identify patients at risk of anthracycline-induced cardiotoxicity. To better understand the different risk-stratifying approaches, we evaluated (123)I-metaiodobenzylguanidine ((123)I-mIBG) scintigraphy and its interrelationship with conventional echocardiography, 2D strain imaging and several biomarkers.
  
  
  METHODS
  We performed (123)I-mIBG scintigraphy, conventional and strain echocardiography and biomarker (NT-proBNP, TNF-α, galectin-3, IL-6, troponin I, ST-2 and sFlt-1) assessment in 59 breast cancer survivors 1 year after anthracycline treatment. Interobserver and intermethod variability was calculated on planar and SPECT (123)I-mIBG scintigraphy, using the heart/mediastinum (H/M) ratio and washout (WO). Pearson's r and multivariate analyses were performed to identify correlations and independent predictors of (123)I-mIBG scintigraphy results.
  
  
  RESULTS
  Delayed planar anterior whole-heart ROI (WH) H/M ratios and WO were the most robust (123)I-mIBG parameters. Significant correlations were observed between (123)I-mIBG parameters and several conventional echo parameters, global longitudinal and radial strain (GLS and GRS) and galectin-3. The highest Pearson's r was observed between delayed H/M ratio and GRS (Pearson's r 0.36, p = 0.01). Multivariate analysis showed that GRS was the only independent predictor of the delayed WH H/M ratio (p = 0.023).
  
  
  CONCLUSIONS
  The delayed planar H/M ratio is the most robust (123)I-mIBG parameter. It correlates with several conventional echocardiographic parameters, GLS, GRS and galectin-3. Of these, only GRS predicts the H/M ratio.
authors.affiliation: MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Zuidhorst Room 2.65, Drienerlolaan 5, PO Box 217, 7500 AE, Enschede, The Netherlands. benbulten@gmail.com.|Department of Radiology and Nuclear Medicine, Radboudumc, Geert Grooteplein 10, Nijmegen, The Netherlands. benbulten@gmail.com.
authors.forename: Ben F
authors.identifier: http://orcid.org/0000-0001-9307-3310
authors.initials: BF
authors.lastname: Bulten
authors.affiliation: Department of Nuclear Medicine, Academic Medical Center, Meibergdreef 9, Amsterdam, The Netherlands.
authors.forename: Hein J
authors.initials: HJ
authors.lastname: Verberne
authors.affiliation: Department of Cardiology, Radboudumc, Geert Grooteplein 10, Nijmegen, The Netherlands.
authors.forename: Louise
authors.initials: L
authors.lastname: Bellersen
authors.affiliation: Department of Radiology and Nuclear Medicine, Radboudumc, Geert Grooteplein 10, Nijmegen, The Netherlands.
authors.forename: Wim J G
authors.initials: WJ
authors.lastname: Oyen
authors.affiliation: Department of Radiology and Nuclear Medicine, Radboudumc, Geert Grooteplein 10, Nijmegen, The Netherlands.|Department of Nuclear Medicine, Hospital Universitari de Bellvitge, Feixa Larga, Barcelona, Spain.
authors.forename: Aida
authors.initials: A
authors.lastname: Sabaté-Llobera
authors.affiliation: Princess Maxima Center for Pediatric Oncology, Lundlaan 6, Utrecht, The Netherlands.
authors.forename: Annelies M C
authors.initials: AM
authors.lastname: Mavinkurve-Groothuis
authors.affiliation: Department of Children's Heart Center, Radboudumc, Geert Grooteplein 10, Nijmegen, The Netherlands.|Pediatric Cardiology Unit, Tel Aviv Sourasky Medical Center, Weizmann Street 10, Tel Aviv, Israel.
authors.forename: Livia
authors.initials: L
authors.lastname: Kapusta
authors.affiliation: Department of Medical Oncology, Academic Medical Center, Meibergdreef 9, Amsterdam, The Netherlands.|Department of Medical Oncology, Radboudumc, Geert Grooteplein 10, Nijmegen, The Netherlands.
authors.forename: Hanneke W M
authors.initials: HW
authors.lastname: van Laarhoven
authors.affiliation: MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Zuidhorst Room 2.65, Drienerlolaan 5, PO Box 217, 7500 AE, Enschede, The Netherlands.|Department of Radiology and Nuclear Medicine, Radboudumc, Geert Grooteplein 10, Nijmegen, The Netherlands.|Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Albinusdreef 2, Leiden, The Netherlands.
authors.forename: Lioe-Fee
authors.initials: LF
authors.lastname: de Geus-Oei
mesh_terms: D019797:3-Iodobenzylguanidine; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood*; D001786:Blood Glucose / Q000032:analysis; D001798:Blood Proteins / Q000032:analysis; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D003520:Cyclophosphamide / Q000008:administration & dosage; D000077143:Docetaxel; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects*; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000097:blood / Q000139:chemically induced* / Q000000981:diagnostic imaging; D006801:Humans; D007457:Iodine Radioisotopes; D008055:Lipids / Q000097:blood; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D015588:Observer Variation; D019275:Radiopharmaceuticals; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D015203:Reproducibility of Results; D012307:Risk Factors; D043823:Taxoids / Q000008:administration & dosage; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D001798:Blood Proteins; D007457:Iodine Radioisotopes; D008055:Lipids; D019275:Radiopharmaceuticals; D043823:Taxoids; D000077143:Docetaxel; D019797:3-Iodobenzylguanidine; D004317:Doxorubicin; D003520:Cyclophosphamide
keywords: 123I-mIBG scintigraphy; 2D strain imaging; Anthracyclines; Biomarkers; Breast cancer; Cardiotoxicity