AUTHOR=Li Shilan , Tian Di , Li Xin , Li Jia , Song Qingwei , Xia Yunlong , Li Zhiyong 

TITLE=Case report: Evaluation of myocardial microcirculation in patients with breast cancer after anthracycline chemotherapy by using intravoxel incoherent motion imaging

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.900309

DOI=10.3389/fcvm.2022.900309

ISSN=2297-055X

ABSTRACT=Introduction: Anthracycline chemotherapy drugs can produce cardiotoxicity in breast cancer patients, leading to myocardial cell death and fibrosis, further developing into cardiac failure. However, condition of myocardial microcirculation was unknown in breast cancer after anthracycline chemotherapy. As a result, Intravoxel Incoherent Motion (IVIM) imaging was used to noninvasively observe condition of myocardial microcirculation in a breast cancer patient after anthracycline chemotherapy.
Case Report: A 43-year-old female patient with right breast mass was reported. Preoperative ultrasound-guided needle biopsy showed invasive carcinoma of right breast with fibronadenoma. Sentinel lymph node biopsy combined with simplified radical surgery for right breast cancer was performed. Postoperative pathological reported breast cancer (pT2N2M0 IIIA). EC-TH chemotherapy scheme of eight period was used, EC and TH scheme was adopted for the first four period and the last four period respectively. During chemotherapy, occurring Grade II myelosuppression, chest CT and abdomen CT showed no metastasis elsewhere, ECG and Cardiac Ultrasound showed normal. Cardiac magnetic resonance cine and IVIM imaging were performed at the beginning of the first chemotherapy (baseline), and after the third, fifth, eighth chemotherapy respectively. We found that ADCfast (ADCfast (fast apparent diffusion coefficient) and f parameters appeared downtrend from the baseline to fifth chemotherapy, IVIMfast valus were 163×10-3 mm2/s, 148×10-3 mm2/s, 134×10-3 mm2/s, and f values were 45%, 36% and 30%, respectively. ADCfast and f values showed rising from fifth chemotherapy and eighth chemotherapy.
Conclusion: Our case showed that IVIM technology is likely to early, noninvasivly and quantitatively observe myocardial microcirculation after anthracyclines chemotherapy in breast cancer patients. In other words, IVIM technology will be very helpful for cardiovascular risk monitoring and prognosis assessment about accurately evaluating status of myocardial microcirculation in breast cancer patients after anthracycline chemotherapy.