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Detection of Myocardial Metabolic Abnormalities by 18F-FDG PET/CT and Corresponding Pathological Changes in Beagles with Local Heart Irradiation

  • Yan, Rui (Nursing College of Shanxi Medical University) ;
  • Song, Jianbo (Department of Nuclear Medicine, First Hospital of Shanxi Medical University) ;
  • Wu, Zhifang (Department of Nuclear Medicine, First Hospital of Shanxi Medical University) ;
  • Guo, Min (Department of Cardiology, First Hospital of Shanxi Medical University) ;
  • Liu, Jianzhong (Department of Nuclear Medicine, First Hospital of Shanxi Medical University) ;
  • Li, Jianguo (Department of Radiological and Environmental Medicine, China Institute for Radiation Protection) ;
  • Hao, Xinzhong (Department of Nuclear Medicine, First Hospital of Shanxi Medical University) ;
  • Li, Sijin (Department of Nuclear Medicine, First Hospital of Shanxi Medical University)
  • Received : 2014.10.14
  • Accepted : 2015.04.24
  • Published : 2015.08.01

Abstract

Objective: To determine the efficacy of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in the detection of radiation-induced myocardial damage in beagles by comparing two pre-scan preparation protocols as well as to determine the correlation between abnormal myocardial FDG uptake and pathological findings. Materials and Methods: The anterior myocardium of 12 beagles received radiotherapy locally with a single X-ray dose of 20 Gy. 18F-FDG cardiac PET/CT was performed at baseline and 3 months after radiation. Twelve beagles underwent two protocols before PET/CT: 12 hours of fasting (12H-F), 12H-F followed by a high-fat diet (F-HFD). Regions of interest were drawn on the irradiation and the non-irradiation fields to obtain their maximal standardized uptake values (SUVmax). Then the ratio of the SUV of the irradiation to the non-irradiation fields (INR) was computed. Histopathological changes were identified by light and electron microscopy. Results: Using the 12H-F protocol, the average INRs were $1.18{\pm}0.10$ and $1.41{\pm}0.18$ before and after irradiation, respectively (p = 0.021). Using the F-HFD protocol, the average INRs were $0.99{\pm}0.15$ and $2.54{\pm}0.43$, respectively (p < 0.001). High FDG uptake in irradiation field was detected in 33.3% (4/12) of 12H-F protocol and 83.3% (10/12) of F-HFD protocol in visual analysis, respectively (p = 0.031). The pathology of the irradiated myocardium showed obvious perivascular fibrosis and changes in mitochondrial vacuoles. Conclusion: High FDG uptake in an irradiated field may be related with radiation-induced myocardial damage resulting from microvascular damage and mitochondrial injury. An F-HFD preparation protocol used before obtaining PET/CT can improve the sensitivity of the detection of cardiotoxicity associated with radiotherapy.

Keywords

References

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