Potential role of epicardial adipose tissue as a biomarker of anthracycline cardiotoxicity.
Authors/Creators
- 1. Department of Biomedical Sciences for Health, Università Degli Studi Di Milano, Via Mangiagalli 31, 20133, Milano, Italy.
- 2. Unit of Radiology, IRCCS Policlinico San Donato, Via Morandi 30, 20097, San Donato Milanese, Italy.
- 3. Department of Biomedical Sciences for Health, Università Degli Studi Di Milano, Via Mangiagalli 31, 20133, Milano, Italy. davide.capra@unimi.it.
- 4. Unit of Medical Oncology, Policlinico Di Monza, Via Amati 111, 20900, Monza, Italy.
- 5. Unit of Medical Oncology, IRCCS Policlinico San Donato, Via Morandi 30, 20097, San Donato Milanese, Italy.
Description
Monti CB, Schiaffino S, Galimberti Ortiz MDM, Capra D, Zanardo M, De Benedictis E, Luporini AG, Spagnolo P, Secchi F, Sardanelli F. Potential role of epicardial adipose tissue as a biomarker of anthracycline cardiotoxicity. Insights Imaging. 2021 Nov 6;12(1):161. doi: 10.1186/s13244-021-01069-4. PMID: 34741673; PMCID: PMC8571675.
Background: We investigated the radiodensity of epicardial (EAT), subcutaneous (SAT), and visceral adipose tissue (VAT) before and after treatment with anthracyclines in a population of breast cancer (BC) patients, and in controls not treated with anthracyclines, to detect a potential role of EAT density as a biomarker of changes related to chemotherapy cardiotoxicity.
Methods: We reviewed BC patients treated with anthracyclines who underwent CT before (CT-t0) and after (CT-t1) chemotherapy, and age- and sex-matched controls who underwent two CT examinations at comparable intervals. On non-contrast scans, EAT was segmented contouring the pericardium and thresholding between -190 and -30 Hounsfield units (HU), and SAT and VAT were segmented with two 15-mm diameter regions of interest thresholded between -195 and -45 HU.
Results: Thirty-two female patients and 32 controls were included. There were no differences in age (p = 0.439) and follow-up duration (p = 0.162) between patients and controls. Between CT-t0 and CT-t1, EAT density decreased in BC patients (-66 HU, interquartile range [IQR] -71 to -63 HU, to -71 HU, IQR -75 to -66 HU, p = 0.003), while it did not vary in controls (p = 0.955). SAT density increased from CT-t0 to CT-t1 in BC patients (-107 HU, IQR -111 to -105 HU, to -105 HU, IQR -110 to -100 HU, p = 0.014), whereas it did not change in controls (p = 0.477). VAT density did not vary in either BC patients (p = 0.911) or controls (p = 0.627).
Conclusions: EAT density appears to be influenced by anthracycline treatment for BC, well known for its cardiotoxicity, shifting towards lower values indicative of a less active metabolism.
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