Role of Three-Dimensional Echocardiography in Breast Cancer: Comparison With Two-Dimensional Echocardiography, Multiple-Gated Acquisition Scans, and Cardiac Magnetic Resonance Imaging

被引:138
作者
Walker, Jonathan
Bhullar, Navdeep
Fallah-Rad, Nazanin
Lytwyn, Matthew
Golian, Mehrdad
Fang, Tielan
Summers, Arthur R.
Singal, Pawan K.
Barac, Ivan
Kirkpatrick, Iain D.
Jassal, Davinder S. [1 ]
机构
[1] Univ Manitoba, Bergen Cardiac Care Ctr, St Boniface Gen Hosp, Dept Internal Med,Div Cardiol,Inst Cardiovasc Sci, Winnipeg, MB R2H 2A6, Canada
关键词
LEFT-VENTRICULAR VOLUME; ADJUVANT CHEMOTHERAPY; RADIONUCLIDE VENTRICULOGRAPHY; EJECTION FRACTION; HEART-FAILURE; FOLLOW-UP; TRASTUZUMAB; CARDIOTOXICITY; QUANTIFICATION; PLUS;
D O I
10.1200/JCO.2009.26.7294
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose In patients with breast cancer, the administration of doxorubicin and trastuzumab is associated with an increased risk of cardiotoxicity. Although multiple-gated acquisition (MUGA) scans and two-dimensional transthoracic echocardiography (TTE) are conventional methods for baseline and serial assessment of left ventricular ejection fraction (LVEF) in these patients, little is known about the use of real-time three-dimensional TTE (RT3D TTE) in this clinical setting. The aim of this study was to assess the accuracy of MUGA, 2D TTE, and RT3D TTE for determining LVEF in comparison to cardiac magnetic resonance imaging (CMR). Methods Between 2007 and 2009 inclusive, 50 female patients with human epidermal growth factor receptor 2-positive breast cancer received adjuvant trastuzumab after doxorubicin. Serial MUGA, 2D TTE, RT3D TTE, and CMR were performed at baseline, 6, and 12 months after the initiation of trastuzumab. Results A comparison of left ventricular end diastolic volume (LVEDV) demonstrated a modest correlation between 2D TTE and CMR (r = 0.64 at baseline; r = 0.69 at 12 months, respectively). A comparison of LVEDV between RT3D TTE and CMR demonstrated a stronger correlation (r = 0.87 at baseline; r = 0.95 at 12 months, respectively). Although 2D TTE demonstrated a weak correlation with CMR for LVEF assessment (r = 0.31 at baseline, r = 0.42 at 12 months, respectively), both RT3D TTE and MUGA showed a strong correlation when compared with CMR (r = 0.91 at baseline; r = 0.90 at 12 months, respectively). Conclusion As compared with conventional MUGA, RT3D TTE is a feasible, accurate, and reproducible alternate imaging modality for the serial monitoring of LVEF in patients with breast cancer.
引用
收藏
页码:3429 / 3436
页数:8
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