MIBG cardiac imaging compared to ejection fraction in evaluation of cardiotoxicity: a systematic review

Advances in diagnosis and treatment of cancer has improved survival but resulted in increased cardiotoxic effects. The decrease in left ventricular ejection fraction (EF), one of the pillars of diagnosis of cardiotoxicity, seems to be a late process in the evolution of the disease, so 123I-metaiodob...

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Bibliographic Details
Published in:Journal of nuclear cardiology 2022-10, Vol.29 (5), p.2274-2291
Main Authors: Arrais, Thaís Rossato, Cavalli, Germano Dallegrave, dos Santos, Bárbara Tietbohl, Pereira, Gabriela Bartzen, Migliavaca, Celina Borges, Grossman, Gabriel Blacher, Biolo, Andréia
Format: Article
Language:English
Subjects:
3-Iodobenzylguanidine
Anthracyclines
Anthracyclines - adverse effects
Cardiac sympathetic activity
Cardiology
Cardiotoxicity
Cardiotoxicity - diagnostic imaging
Chemotherapy
Ejection fraction
Heart - innervation
Humans
Imaging
Medicine
Medicine & Public Health
MIBG
Monoclonal antibodies
Nuclear Medicine
Radiology
Review Article
Stroke Volume
Systematic review
Targeted cancer therapy
Trastuzumab
Ventricular Function, Left
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Summary:Advances in diagnosis and treatment of cancer has improved survival but resulted in increased cardiotoxic effects. The decrease in left ventricular ejection fraction (EF), one of the pillars of diagnosis of cardiotoxicity, seems to be a late process in the evolution of the disease, so 123I-metaiodobenzylguanidine (MIBG) cardiac imaging has been proposed to detect early cardiac impairment. The aim of this systematic review was to evaluate the performance of MIBG cardiac scan in this scenario. A systematic search was conducted in five international databases comparing MIBG parameters with EF for evaluation of cardiotoxicity. Twelve studies were included and separated in three groups. First, studies evaluating patients with established cardiotoxicity, in which EF was reduced and MIBG parameters were abnormal. Second, studies analyzing patients during or after treatment compared to controls, with MIBG parameters significantly different between groups in most studies, even when EF remained normal. Finally, studies analyzing anthracycline (ATC) dose-related changes, with alteration in MIBG parameters occurring even when EF was preserved. Although studies had high methodological variability, cardiac sympathetic innervation imaging seems to be a promising tool for assessing early cardiotoxicity. Further studies are needed to analyze its diagnostic value in this scenario.
ISSN:1071-3581
1532-6551
DOI:10.1007/s12350-021-02610-0