Reduced homogeneous myocardial [18F]FDG uptake in routine PET/CT studies as an early indicator of chemotherapy-Induced cardiotoxicity

Resumen

Cardiotoxicity refers to the damage induced by antineoplastic treatments, leading to various cardiovascular conditions. [F-18]FDG PET radiomics analysis could provide relevant information on early onset changes occurring in cardiac metabolism of chemotherapy-induced cardiotoxicity. Patients' sociodemographic data, cardiovascular risk factors, laboratory parameters, and left ventricle [F-18]FDG PET radiomic features are analyzed. The H-Rad index for the quantification of the heterogeneity of the metabolic uptake patterns is proposed. Statistical analysis is performed by separating patients according to the diagnosis of cancer therapy-related cardiac dysfunction (CTRCD). Baseline, intermediate, and end-of-treatment scans are evaluated as separate groups. Overall, CTRCD+ patients show lower overall mean standardized uptake values (SUVmean) compared to CTRCD- patients, with statistically significant differences between groups only observed in the intermediate PET study (p = 0.025). A total of 34 radiomic features show statistically significant differences between the CTRCD+ and CTRCD- groups in the intermediate imaging studies. In the CTRCD- group, greater overall heterogeneity of metabolic uptake is observed in the intermediate PET image compared to the CTRCD+ groups (p = 0.025). The assessment of CTRCD through [F-18]FDG PET radiomics analysis could be a potential tool for the identification of a predisposition to the later development of cardiac complications after cardiotoxic treatment.