Radionuclide evaluation of doxorubicin cardiotoxicity: the need for cautious interpretation

Serial radionuclide angiography is a sensitive technique for the identification of asymptomatic cardiac dysfunction secondary to doxorubicin hydrochloride chemotherapy. However, the results of serial studies must be interpreted with caution in order to avoid labeling variations in the left ventricular ejection fraction (LVEF) due to artifact as doxorubicin cardiotoxicity. The use of sequential gated cardiac studies in the evaluation of a thirteen-year-old boy on doxorubicin hydrochloride is presented. Reassessment of the results of these studies showed that technical and biologic factors were the cause of recurring fluctuations in the LVEF, rather than drug toxicity.