Changes in cardiac volume determined with repeated enhanced 4DCT during chemoradiotherapy for esophageal cancer
Abstract Background Concurrent chemoradiotherapy is considered curative intent treatment for patients with non-operative esophageal cancer. Radiation-induced heart damage receives much attention. We performed repeated four-dimensional computed tomography (4DCT) to detect changes in cardiac volume du...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2018-09-01
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| Series: | Radiation Oncology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13014-018-1121-z |
| _version_ | 1831789432503533568 |
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| author | Xue Wang Jin-Zhi Wang Jian-Bin Li Ying-Jie Zhang Feng-Xiang Li Wei Wang Yan-Luan Guo Qian Shao Min Xu Xi-Jun Liu Yue Wang |
| author_facet | Xue Wang Jin-Zhi Wang Jian-Bin Li Ying-Jie Zhang Feng-Xiang Li Wei Wang Yan-Luan Guo Qian Shao Min Xu Xi-Jun Liu Yue Wang |
| author_sort | Xue Wang |
| collection | DOAJ |
| description | Abstract Background Concurrent chemoradiotherapy is considered curative intent treatment for patients with non-operative esophageal cancer. Radiation-induced heart damage receives much attention. We performed repeated four-dimensional computed tomography (4DCT) to detect changes in cardiac volume during radiotherapy for esophageal cancer patients, and explored potential factors responsible for those changes. Methods Forty-six patients with esophageal cancer underwent enhanced 4DCT and three-dimensional (3D) CT scans before radiotherapy and every 10 fractions during treatment. The heart was contoured on 3DCT images, 4DCT end expiratory (EE) images and 4DCT maximum intensity projection (MIP) images by the same radiation oncologist. Heart volumes and other relative parameters were compared by the SPSS software package, version 19.0. Results Compared with its initial value, heart volume was smaller at the 10th fraction (reduction = 3.27%, 4.45% and 4.52% on 3DCT, EE and MIP images, respectively, p < 0.05) and the 20th fraction (reduction = 6.05%, 5.64% and 4.51% on 3DCT, EE and MIP images, respectively, p < 0.05), but not at the 30th fraction. Systolic and diastolic blood pressures were reduced (by 16.95 ± 16.69 mmHg and 7.14 ± 11.64 mmHg, respectively, both p < 0.05) and the heart rate was elevated by 5.27 ± 6.25 beats/min (p < 0.05) after radiotherapy. None of the potential explanatory variables correlated with heart volume changes. Conclusions Cardiac volume reduced significantly from an early treatment stage and maintained the reduction until the middle stage. The heart volume changes observed on 3DCT and 4DCT were consistent during radiotherapy. The changes in heart volume, blood pressure and heart rate may be valuable indicators of cardiac impairment and target dose changes. |
| first_indexed | 2024-12-22T14:09:30Z |
| format | Article |
| id | doaj.art-abacefba54214db08ea1b66917f3c55f |
| institution | Directory Open Access Journal |
| issn | 1748-717X |
| language | English |
| last_indexed | 2024-12-22T14:09:30Z |
| publishDate | 2018-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj.art-abacefba54214db08ea1b66917f3c55f2022-12-21T18:23:14ZengBMCRadiation Oncology1748-717X2018-09-011311910.1186/s13014-018-1121-zChanges in cardiac volume determined with repeated enhanced 4DCT during chemoradiotherapy for esophageal cancerXue Wang0Jin-Zhi Wang1Jian-Bin Li2Ying-Jie Zhang3Feng-Xiang Li4Wei Wang5Yan-Luan Guo6Qian Shao7Min Xu8Xi-Jun Liu9Yue Wang10School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical SciencesDepartment of Thoracic Radiation Oncology, Shandong Cancer Hospital affiliated to Shandong University, Shandong Academy of Medical SciencesDepartment of Thoracic Radiation Oncology, Shandong Cancer Hospital affiliated to Shandong University, Shandong Academy of Medical SciencesDepartment of Thoracic Radiation Oncology, Shandong Cancer Hospital affiliated to Shandong University, Shandong Academy of Medical SciencesDepartment of Thoracic Radiation Oncology, Shandong Cancer Hospital affiliated to Shandong University, Shandong Academy of Medical SciencesDepartment of Thoracic Radiation Oncology, Shandong Cancer Hospital affiliated to Shandong University, Shandong Academy of Medical SciencesDepartment of PET-CT Room, Shandong Cancer Hospital affiliated to Shandong University, Shandong Academy of Medical SciencesDepartment of Thoracic Radiation Oncology, Shandong Cancer Hospital affiliated to Shandong University, Shandong Academy of Medical SciencesDepartment of Thoracic Radiation Oncology, Shandong Cancer Hospital affiliated to Shandong University, Shandong Academy of Medical SciencesDepartment of Thoracic Radiation Oncology, Shandong Cancer Hospital affiliated to Shandong University, Shandong Academy of Medical SciencesMedical imaging department, Shandong Cancer Hospital affiliated to Shandong University, Shandong Academy of Medical SciencesAbstract Background Concurrent chemoradiotherapy is considered curative intent treatment for patients with non-operative esophageal cancer. Radiation-induced heart damage receives much attention. We performed repeated four-dimensional computed tomography (4DCT) to detect changes in cardiac volume during radiotherapy for esophageal cancer patients, and explored potential factors responsible for those changes. Methods Forty-six patients with esophageal cancer underwent enhanced 4DCT and three-dimensional (3D) CT scans before radiotherapy and every 10 fractions during treatment. The heart was contoured on 3DCT images, 4DCT end expiratory (EE) images and 4DCT maximum intensity projection (MIP) images by the same radiation oncologist. Heart volumes and other relative parameters were compared by the SPSS software package, version 19.0. Results Compared with its initial value, heart volume was smaller at the 10th fraction (reduction = 3.27%, 4.45% and 4.52% on 3DCT, EE and MIP images, respectively, p < 0.05) and the 20th fraction (reduction = 6.05%, 5.64% and 4.51% on 3DCT, EE and MIP images, respectively, p < 0.05), but not at the 30th fraction. Systolic and diastolic blood pressures were reduced (by 16.95 ± 16.69 mmHg and 7.14 ± 11.64 mmHg, respectively, both p < 0.05) and the heart rate was elevated by 5.27 ± 6.25 beats/min (p < 0.05) after radiotherapy. None of the potential explanatory variables correlated with heart volume changes. Conclusions Cardiac volume reduced significantly from an early treatment stage and maintained the reduction until the middle stage. The heart volume changes observed on 3DCT and 4DCT were consistent during radiotherapy. The changes in heart volume, blood pressure and heart rate may be valuable indicators of cardiac impairment and target dose changes.http://link.springer.com/article/10.1186/s13014-018-1121-zEsophageal cancerConcurrent chemoradiotherapyHeart volume changeContrast enhanced four-dimensional computed tomographyBlood pressure |
| spellingShingle | Xue Wang Jin-Zhi Wang Jian-Bin Li Ying-Jie Zhang Feng-Xiang Li Wei Wang Yan-Luan Guo Qian Shao Min Xu Xi-Jun Liu Yue Wang Changes in cardiac volume determined with repeated enhanced 4DCT during chemoradiotherapy for esophageal cancer Radiation Oncology Esophageal cancer Concurrent chemoradiotherapy Heart volume change Contrast enhanced four-dimensional computed tomography Blood pressure |
| title | Changes in cardiac volume determined with repeated enhanced 4DCT during chemoradiotherapy for esophageal cancer |
| title_full | Changes in cardiac volume determined with repeated enhanced 4DCT during chemoradiotherapy for esophageal cancer |
| title_fullStr | Changes in cardiac volume determined with repeated enhanced 4DCT during chemoradiotherapy for esophageal cancer |
| title_full_unstemmed | Changes in cardiac volume determined with repeated enhanced 4DCT during chemoradiotherapy for esophageal cancer |
| title_short | Changes in cardiac volume determined with repeated enhanced 4DCT during chemoradiotherapy for esophageal cancer |
| title_sort | changes in cardiac volume determined with repeated enhanced 4dct during chemoradiotherapy for esophageal cancer |
| topic | Esophageal cancer Concurrent chemoradiotherapy Heart volume change Contrast enhanced four-dimensional computed tomography Blood pressure |
| url | http://link.springer.com/article/10.1186/s13014-018-1121-z |
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