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Related Concept Videos

Radiological Investigation III: Pulmonary Angiogram and PET Scan01:13

Radiological Investigation III: Pulmonary Angiogram and PET Scan

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Radiological investigations are paramount in the diagnosis and management of various pulmonary diseases. Two essential investigations are the Pulmonary Angiogram and the Positron Emission Tomography (PET) Scan.
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
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Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
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Updated: Jun 3, 2025

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Predictors of Atrial Fibrillation After Thoracic Radiotherapy.

Santino Butler1, Hyunsoo No1, Felicia Guo1

  • 1Department of Radiation Oncology, Stanford University School of Medicine, Palo Alto, California, USA.

JACC. Cardiooncology
|January 13, 2025
PubMed
Summary
This summary is machine-generated.

Thoracic radiotherapy dose to pulmonary veins (PVs) significantly predicts atrial fibrillation (AF) risk. Higher PV maximum dose (dmax) increases AF incidence, regardless of patient risk factors, emphasizing cardiac substructure importance in radiation toxicity.

Keywords:
Hodgkin lymphomabreast canceresophageal cancerleft coronary arteriesmyocardial sleevesnon–small cell lung cancerpulmonary veinsradiation toxicity

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Area of Science:

  • Cardiology
  • Radiation Oncology
  • Medical Physics

Background:

  • Atrial fibrillation (AF) is a known complication of thoracic radiotherapy.
  • The specific cardiac substructures contributing to AF risk after radiation are not well-defined.

Purpose of the Study:

  • To investigate the association between irradiation of specific cardiac substructures and the risk of developing clinically significant (grade ≥3) AF.
  • To identify dose metrics for cardiac substructures that predict AF incidence.

Main Methods:

  • Analysis of data from 539 patients treated with definitive radiotherapy for localized cancers (lung, breast, lymphoma, esophageal).
  • Calculation of 2-Gy fraction equivalent dose for cardiac substructures: pulmonary veins (PVs), left atrium, sinoatrial node, and coronary arteries.
  • Use of competing risk models adjusted for the Mayo AF risk score (MAFRS) to assess AF incidence.

Main Results:

  • Increased AF risk was associated with higher PV maximum dose (dmax) (sHR: 1.22), larger left atrial volume (sHR: 1.01), smoking history (sHR: 1.01), and higher MAFRS (sHR: 1.16).
  • PV dmax was a significant predictor of AF across different MAFRS subgroups.
  • A PV dmax >39.7 Gy was linked to higher AF risk, independent of MAFRS.

Conclusions:

  • Pulmonary vein maximum dose (PV dmax) is a significant predictor of grade ≥3 AF, irrespective of other risk factors.
  • These findings underscore the critical role of cardiac substructures in radiation-induced toxicity.
  • Further validation of PV dose metrics in clinical settings is recommended to mitigate AF risk.