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18F-FDG PET/CT findings of radiotherapy-related myocardial changes in patients with thoracic malignancies

Unal, Kemala; Unlu, Mustafab; Akdemir, Ozgurb; Akmansu, Mugec

doi: 10.1097/MNM.0b013e328362f824
Original Articles

Objective The purpose of this study was to investigate myocardial findings of 18F-fluorodeoxyglucose PET/computed tomography (18F-FDG PET/CT) after thoracic radiotherapy.

Methods 18F-Fluorodeoxyglucose PET/CT examination was performed in 38 patients at least 4 months after radiotherapy. Patients with known cardiac diseases, high cardiovascular risk factors, or diabetes mellitus were excluded.

Results On visual analysis, 28 patients were seen to have regional myocardial 18F-FDG uptake (74%), five patients were seen to have diffuse myocardial 18F-FDG uptake (13%), and five patients were seen to have no significant myocardial 18F-FDG uptake (13%). Regions of interest were drawn on irradiated and nonirradiated segments of the myocardium. The standardized uptake value measurements of the 28 patients with regional myocardial 18F-FDG uptake revealed significantly higher values in the irradiated segments in comparison with nonirradiated segments (P<0.001).

Conclusion Annular or focal increased 18F-FDG uptake in irradiated myocardial segments may be observed after thoracic radiotherapy. These myocardial uptake regions were not consistent with the vascular territory of coronary arteries, and the patients had no prior myocardial infarction or coronary artery disease. The patients with a history of thoracic radiotherapy, who showed increased 18F-FDG uptake on PET/CT, especially in the basal myocardium, should be followed up cautiously for the early diagnosis of cardiac events.

aDepartment of Nuclear Medicine, Izmir University, Izmir

Departments of bNuclear Medicine

cRadiation Oncology, Gazi University, Ankara, Turkey

Correspondence to Kemal Unal, MD, Yeni Girne Bulv. Medicalpark Hospital, 1825. sk. Karsiyaka, Izmir 35575, Turkey Tel: +90 505 4526805; fax: +90 232 3995075; e-mail:

Received January 31, 2013

Accepted May 6, 2013

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins