Potential role of epicardial adipose tissue as a biomarker of anthracycline cardiotoxicity.
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Monti CB, Schiaffino S, Galimberti Ortiz MDM, Capra D, Zanardo M, De Benedictis E, Luporini AG, Spagnolo P, Secchi F, Sardanelli F. Potential role of epicardial adipose tissue as a biomarker of anthracycline cardiotoxicity. Insights Imaging. 2021 Nov 6;12(1):161. doi: 10.1186/s13244-021-01069-4. PMID: 34741673; PMCID: PMC8571675. <strong>Background: </strong>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. <strong>Methods: </strong>We reviewed BC patients treated with anthracyclines who underwent CT before (CT-t<sub>0</sub>) and after (CT-t<sub>1</sub>) 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. <strong>Results: </strong>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<sub>0</sub> and CT-t<sub>1</sub>, 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<sub>0</sub> to CT-t<sub>1</sub> 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). <strong>Conclusions: </strong>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.
