The role of 18F-FDG PET/BT? and myocardial perfusion scintigraphy in the evaluation of cardiac damage after radiotherapy

In this thesis, the list of the patients who undergone 18F-FDG PET/CT examination at the Gazi University Nuclear Medicine Department, and the list of the patients who undergone mediastinal radiotherapy at the Gazi University Radiation Oncology Department were matched. 18F-FDG PET/CT examination was performed in 38 patients at least 4 months after the radiotherapy. Most of the patients had lung cancer (89.5%). In the database check, it was found that 8 of the patients had also undergone myocardial perfusion scintigraphy. In the visual analysis, 5 patients had diffuse myocardial 18F-FDG uptake (13%), 5 patients had no significant 18F-FDG uptake (13%) and 28 patients had regional 18F-FDG uptake (74%). The SUV calculations of these 28 patients were significantly higher in the irradiated regions in comparison to other myocardial regions (p<0.001). 6 of the 8 patients that were undergone myocardial perfusion scintigraphy showed fixed hypoperfusion in the irradiated myocardial regions in consistent with the regions that increased 18F-FDG PET/CT uptake was seen. There was no correlation between the radiotherapy doses and the SUV measurements in the myocardial regions. Since the patients had no myocardial infarction or diabetes and these myocardial regions were not consistent with the vascular territory of coronary arteries, the findings might were thought to indicate radiation induced myocardial damage. The patients with mediastinal radiotherapy history that showed increased 18F-FDG uptake, especially in the basal myocardium, should be followed cautiously for the early diagnosis and treatment of cardiac events.