Objective:

To develop and validate an image processing tool for the qualitative and quantitative analysis of myocardial uptake in [18F]FDG PET/CT scans, aiming to enhance early detection of anthracycline-induced cardiotoxicity, which is critical for improving patient outcomes.

Key Findings:

• Echocardiography's variability limits early detection of cardiotoxicity, necessitating improved methods.
• Myocardial glucose metabolism assessed by [18F]FDG PET/CT may identify cardiac toxicity earlier than LVEF changes, highlighting its potential as a superior diagnostic tool.
• Abnormal uptake patterns in PET scans correlate with cardiac diseases, including LV dysfunction, suggesting a need for further exploration of these patterns in clinical settings.

Interpretation:

The proposed image processing tool enhances the ability to detect myocardial metabolic changes associated with anthracycline-induced cardiotoxicity, potentially improving patient monitoring and outcomes, and paving the way for more personalized treatment strategies.

Limitations:

• Retrospective study design may introduce selection bias, which should be considered when interpreting results.
• Variability in myocardial glucose uptake due to external factors may affect results, indicating a need for standardized protocols.
• Limited generalizability to other chemotherapy regimens not involving anthracyclines, suggesting further studies are needed to validate findings across diverse patient populations.

Conclusion:

The image processing tool shows promise for improving the detection of cardiotoxicity in cancer patients undergoing anthracycline treatment, warranting further validation in larger cohorts and exploration of its clinical applications.