Application value of 99m Tc-MIBI SPECT/CT gated myocardial perfusion imaging in diagnosis of radiation-induced heart damage caused by radiotherapy for postoperative breast cancer
Objective To investigate the value of 99m Tc-MIBI SPECT/CT GMPI in the diagnosis of radiation-induced heart disease(RIHD)after breast cancer surgery.Methods 72 patients with breast cancer who received radiotherapy in the department of Radiotherapy of our hospital were collected.All patients underwent 2-day resting and exercise 99m Tc-MIBI SPECT/CT GMPI before and after radiotherapy.The semi-quantitative parameters of GMPI and left ventricular function evaluation indexes before and after radio-therapy were compared.Results 19.4%patients had myocardial ischemia before radiotherapy.59.7%patients were found to have myo-cardial ischemia after radiotherapy.The number of patients was significantly higher than that before radiotherapy,and the difference was statistically significant(P<0.05).The semiquantitative parameters SRS,SSS,SDS and TPD of MPI after radiotherapy were higher than those before radiotherapy,the differences were statistically significant(P<0.05).After radiotherapy,SRS,SSS,SDS and TPD were sig-nificantly correlated with the age of patients,and were positively correlated,and the differences were statistically significant(P<0.05).There was a significant and negative correlation with body mass index(P<0.05).The mean values of SSS,SRS,SDS and TPD in pa-tients with tumor located on the left side and radical operation were significantly higher than those in patients with tumor located on the right side and breast conserving operation,and the differences were statistically significant(P<0.05).There was no significant differ-ence between left ventricular function parameters EDV,ESV,LVEF and resting GMPI before radiotherapy(P>0.05).There was no sig-nificant difference in left ventricular function parameters EDV and ESV of GMPI after radiotherapy compared with those at rest(P>0.05).However,the LVEF value obtained by GMPI after radiotherapy was lower than that by Cardiac color Doppler ultrasound and the difference was statistically significant(P<0.05).Conclusion 99m Tc-MIBI SPECT/CT GMPI can not only judge the extent and sever-ity of myocardial ischemia after radiotherapy from visual and semi-quantitative indicators,but also can evaluate the left ventricular func-tion after radiotherapy by EDV,ESV and LVEF,which can be used as an important examination method to evaluate the cardiac injury caused by radiotherapy after breast cancer.
Breast cancerRadiotherapy99mTc-MIBISPECT/CTGMPIRIHD
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