Several studies reported an increased rate of cardiac events related to left-sided breast irradiation1-4.The purpose of this study is to improve our understanding of the nature of radiation effects on the human organism in general and on the heart in particular by detecting cardiac alterations prior to clinical symptoms and, potentially, to optimize means of early intervention. In the last three decades radiobiological studies have shown that late myocardial irradiation damages can eventually cause coronary heart disease through a process which is not yet fully...

Dosimetric data was analyzed retrospectively from planning CTs of 22 patients who were treated withleft-sided tangential whole-breast irradiation between the years 2009-2010. Cardiac MRI (3T) of these patients was performed 7±0.3 years after this therapy. We assessed LV function, perfusion as well as fibrosis and extracellular volume (LGE/ECV) and compared them to reference values. Quantitative evaluation of myocardial blood flow was performed at rest and stress using a saturation-recovery FLASH sequence covering three short-axis slices. T1 maps for ECV estimation were acquired using a modified...

The results of the MRI analysis are shown in Table 1. In the anatomical correlation of CT planning sequences and MR images no association of irradiation dose and cardiac alterations was found. Basically, there were no cardiac alterations detectable, as shown in Fig. 1-3. Table 1: List of MRI derived values n=22 Age (y) EF % ESV ml EDV ml ECV % Native T1 msec Stress flow ml/min/g Patients 65 ± 12 59 ± 10 31 ± 18 74 ± 25 26.4 ± 1.5 1220...

No significant effect of the radiotherapy on structural or functional cardiac parameters was observed within the observation interval with the applied MRI technique. In accordance to that there was no anatomical correlation verified between the irradiation dose and cardiac alterations. This is in contrary to several other studies, which described cardiac alterations such as wall motion abnormalities due to myocardial perfusion defects in patients with left-sided breast irradiation2-3. Seddon et al.4detected perfusion deficits with a SPECT myocardial scintigraphy in 70.8% of the patients with left...

A. Zeh, Doctoral Candidate Technical University of Munich (TUM), Klinikum Rechts der Isar Munich, Department of Radiooncology Ismaningerstr. 22 81675 Munich, Germany e-mail: [email protected]

Marks LB, Yu X, Prosnitz RG, Zhou SM, Hardenbergh PH, Blazing M, Hollis D, Lind P, Tisch A, Wong TZ and Borges-Neto S. The incidence and functional consequences of RT-associated cardiac perfusion defects. International journal of radiation oncology, biology, physics. 2005;63:214-23. Prosnitz RG, Hubbs JL, Evans ES, Zhou SM, Yu X, Blazing MA, Hollis DR, Tisch A, Wong TZ, Borges-Neto S, Hardenbergh PH and Marks LB. Prospective assessment of radiotherapy-associated cardiac toxicity in breast cancer patients: analysis of data 3 to 6 years after treatment....