Coronary artery disease after radiation therapy for Hodgkin's lymphoma: Coronary CT angiography findings and calcium scores in nine asymptomatic patients Journal Article
| Authors: | Rademaker, J.; Schoder, H.; Ariaratnam, N. S.; Strauss, H. W.; Yahalom, J.; Steingart, R.; Oeffinger, K. C. |
| Article Title: | Coronary artery disease after radiation therapy for Hodgkin's lymphoma: Coronary CT angiography findings and calcium scores in nine asymptomatic patients |
| Abstract: | OBJECTIVE. Long-term survivors of Hodgkin's lymphoma treated with radiation therapy have an increased incidence of coronary artery disease. The purpose of this study is to describe the coronary CT angiography findings and calcium scores of asymptomatic patients who had mediastinal irradiation for Hodgkin's lymphoma and to evaluate the impact of coronary CT angiography on patient management. MATERIALS AND METHODS. We evaluated nine consecutive patients, age range 35-60 years, who had been treated for Hodgkin's lymphoma by radiation therapy between the ages of 11 and 27 years. The total mediastinal dose ranged from 34 to 45 Gy. All patients were evaluated with 64-MDCT with calcium scoring followed by CT angiography of the coronary arteries. Imaging findings and clinical follow-up were analyzed. RESULTS. Eight of nine patients had coronary artery disease. CT showed long segments of diffuse disease; areas of stenosis from soft plaque; and calcification in the proximal right coronary, left anterior descending, and left circumflex arteries. Calcium scores were significantly higher than in other patients of this age group. Additional tests, including selective coronary angiography, were necessary in patients with diffuse disease with calcifications. CT evaluation led to bypass surgery and angioplasty in two patients. CONCLUSION. Coronary CT angiography and calcium scores are useful tools for evaluation of irradiation-related coronary artery disease. Complementary tests might be necessary in selected patients. Prospective larger studies are needed to better define the role of coronary CT angiography and calcium scores and to establish an algorithm for evaluation and treatment of these patients. © American Roentgen Ray Society. |
| Keywords: | adult; clinical article; middle aged; cancer radiotherapy; radiation dose; follow up; sensitivity and specificity; reproducibility of results; image analysis; radiotherapy; incidence; tomography, x-ray computed; calcium; retrospective study; hodgkin disease; cancer survivor; diagnostic value; device; scoring system; radiation injuries; coronary artery bypass surgery; coronary artery atherosclerosis; coronary artery disease; computed tomographic angiography; multidetector computed tomography; artery calcification; calcinosis; coronary angiography; coronary ct angiography; calcium score; hodgkin's disease; mantle field radiation; iodixanol; agatston score; coronary artery obstruction; transluminal coronary angioplasty |
| Journal Title: | American Journal of Roentgenology |
| Volume: | 191 |
| Issue: | 1 |
| ISSN: | 0361-803X |
| Publisher: | American Roentgen Ray Society |
| Date Published: | 2008-07-01 |
| Start Page: | 32 |
| End Page: | 37 |
| Language: | English |
| DOI: | 10.2214/ajr.07.3112 |
| PUBMED: | 18562721 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 12" - "Export Date: 17 November 2011" - "CODEN: AJROA" - "Source: Scopus" |
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