Potential role of epicardial adipose tissue as a biomarker of anthracycline cardiotoxicity

• Published in: Insights into imaging Vol. 12; no. 1; pp. 1 - 8
• Main Authors: Monti, Caterina Beatrice, Schiaffino, Simone, Galimberti Ortiz, Maria Del Mar, Capra, Davide, Zanardo, Moreno, De Benedictis, Elena, Luporini, Alberto Gianluigi, Spagnolo, Pietro, Secchi, Francesco, Sardanelli, Francesco
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 06-11-2021; Springer Nature B.V; SpringerOpen
• Subjects: Adipose tissue; Anthracyclines; Biomarkers; Body fat; Breast cancer; Breast neoplasms; Cardiotoxicity; Chemotherapy; Contouring; Density; Diagnostic Radiology; Imaging; Internal Medicine; Interventional Radiology; Medicine; Medicine & Public Health; Neuroradiology; Original; Original Article; Pericardium; Radiology; Tomography, X-ray computed; Ultrasound; Biomarkers; Tomography, X-ray computed; Anthracyclines; Breast neoplasms; Cardiotoxicity
• ISSN: 1869-4101; 1869-4101
• DOI: 10.1186/s13244-021-01069-4

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-t
0
) and after (CT-t
1
) 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-t
0
and CT-t
1
, 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-t
0
to CT-t
1
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.