2235 - Assessment of Myocardial Perfusion and Fibrosis after Radiotherapy for Thoracic Malignancies: A Comparative Study between Esophageal and Non-Esophageal Cancer

03:00pm - 04:00pm ET

Poster Hall - Exhibit Hall A

Screen: 25

POSTER

Presenter(s)

Akinori Takada, MD, PhD - Mie university, Tsu, Mie

A. Takada Sr¹, Y. Toyomasu¹, T. Mase¹, K. Omori¹, A. Taniguchi¹, K. Saihara¹, Y. Suzuki², S. Nakamura³, and Y. Nomoto¹; ¹Department of Radiology, Mie University Hospital, Tsu, Mie, Japan, ²Mie university hospital, Tsu city, Japan, ³Department of Advanced Diagnostic Imaging, Mie University Graduate School of Medicine, Tsu, Mie, Japan

Purpose/Objective(s): In radiation therapy for esophageal cancer, cardiac radiation exposure tends to be higher than in other malignancies, and an increased risk of cardiac-related mortality has been reported. This study aimed to evaluate and compare the incidence of myocardial perfusion abnormalities and fibrosis using post-treatment cardiac CT and MRI in patients who underwent thoracic irradiation at our institution.

Materials/Methods: We retrospectively analyzed 20 patients with thoracic malignancies who received radiation therapy at our institution between March 2017 and October 2023 and subsequently underwent both cardiac CT and MRI one year after treatment. We assessed the presence of coronary artery stenosis, reduced myocardial perfusion, and myocardial fibrosis. In addition, the left ventricular global extracellular volume fraction (Global ECV) was quantitatively measured using MRI. Global ECV values were compared between the esophageal cancer group and the non-esophageal cancer group using the Mann–Whitney U test.

Results: The cohort consisted of 8 patients with esophageal cancer, 7 with breast cancer, 4 with malignant lymphoma, and 1 with lung cancer. One year after treatment, reduced myocardial perfusion on cardiac CT was observed in 12 patients (60%), and myocardial fibrosis on cardiac MRI was detected in 5 patients (25%). The overall median (IQR) left ventricular Global ECV was 31.2 (29.4–33.8). The median (IQR) Global ECV values in the esophageal cancer and non-esophageal cancer groups were 31.7 (31.0–35.4) and 29.9 (28.6–32.0), respectively. Global ECV was significantly higher in the esophageal cancer group (p = 0.037).

Conclusion: Myocardial perfusion abnormalities were frequently observed after thoracic radiation therapy. In particular, patients with esophageal cancer demonstrated a higher risk of developing myocardial fibrosis, underscoring the importance of early evaluation for radiation-induced cardiac injury.