Abstract 12510: Monitoring of Chemotherapy-Induced Vascular Toxicity in Pediatric, Adolescent, and Young Adult Lymphomas Using PET/CT Imaging

Abstract

Introduction: Lymphoma treatment with chemotherapy, alone or in combination with radiation therapy, can have off-target effects that lead to vascular toxicity, which has recently gained attention in the field of cardio-oncology. Positron emission tomography (PET)/computed tomography (CT) imaging with fluorine-18 ( 18 F)-fluorodeoxyglucose (FDG) is standard of care for monitoring lymphoma treatment responses and is a widely accepted tool for assessing vascular inflammation. We hypothesized that 18 F-FDG PET/CT imaging could detect and quantify chemotherapy-induced increases in vascular inflammation following the first cycle of lymphoma treatment in pediatric, adolescent, and young adult (AYA) patients. Methods: Whole-body 18 F-FDG PET/CT images were retrospectively acquired at initial staging of disease and first treatment follow-up for pediatric and AYA lymphoma patients (n=33). Regions of interest were manually drawn using each axial slice of fused PET/CT images for the femoral and popliteal arteries/veins to quantify serial changes in vascular uptake of 18 F-FDG. The changes in the average maximum standard uptake value (SUV max ) for the femoral-popliteal vessels were calculated. Results and Conclusions: The patient population consisted of Non-Hodgkin (55%) and Hodgkin (45%) lymphoma patients with a mean age of 13 years (SD=4.7). 18 F-FDG PET/CT imaging detected ( Fig. 1A ) and quantified a significant increase in the mean SUV max from baseline (0.94±0.03) to first treatment follow-up (1.06±0.02) for the femoral and popliteal arteries/veins ( Fig. 1B ). Standard of care 18 F-FDG PET/CT imaging can non-invasively quantify chemotherapy-induced vascular inflammation in young cancer patients in response to the first cycle of treatment, thus representing an approach for evaluating vascular toxicity and creating novel opportunities for personalized medicine focused on reducing cardiovascular side effects of chemotherapy.