FDG PET scanning suggests that 5FU myocardial toxicity is metabolic, rather than ischaemic

Date 28 June 2017
Event ESMO World Congress on Gastrointestinal Cancer 2017
Session ESMO World Congress on Gastrointestinal Cancer 2017
Topics Gastrointestinal Cancers
Palliative and Supportive Care
Presenter Domenic Higgs
Citation Annals of Oncology (2017) 28 (suppl_3): iii13-iii136. 10.1093/annonc/mdx261
Authors D. Higgs, P. Robins, P. Stobie, P. Craven, C. Daly, S. Carija
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Abstract

The exact mechanism of fluoropyrimidine associated myocardial toxicity has not been determined but has traditionally been said to be due of coronary artery spasm. The chance discovery of abnormal FDG uptake in the myocardium of a patient with chest pain, ECG changes and a raised troponin whilst receiving infusional 5-FU led to us prospectively investigating all incidences of chest pain occurring during 5-FU-based treatment with FDG PET scanning.

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The aim of our study is to report 6 consecutive cases of abnormal FDG PET studies in patients receiving 5-FU with the results supporting a metabolic effect on the heart rather than impairment of arterial perfusion. This would support Matsubara's description of Krebs cycle dysfunction in a guinea pig exposed to 5-FU with notable ECG changes.

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The aim of our study is to report 6 consecutive cases of abnormal FDG PET studies in patients receiving 5-FU with the results supporting a metabolic effect on the heart rather than impairment of arterial perfusion. This would support Matsubara's description of Krebs cycle dysfunction in a guinea pig exposed to 5-FU with notable ECG changes.