FDG-PET Imaging of Doxorubicin-Induced Cardiotoxicity: a New Window on an Old Problem

  • Matteo BaucknehtEmail author
  • Vanessa Cossu
  • Alberto Miceli
  • Maria Isabella Donegani
  • Selene Capitanio
  • Silvia Morbelli
  • Cecilia Marini
  • Gianmario Sambuceti
Cardiac Nuclear Imaging (A Cuocolo and M Petretta, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Cardiac Nuclear Imaging


Purpose of Review

The present review focus on the published literature about the use of 18F-fluorodeoxyglucose (FDG) PET/CT imaging in the early recognition of anthracyclines-related cardiotoxicity.

Recent Findings

The application of PET/CT may represent an early predictor of subsequent cardiotoxicity in cancer patients treated with doxorubicin (DXR). However, the application of PET/CT may also extend beyond mere cardiotoxicity identification and monitoring to provide mechanistic delineation of the cardiotoxic pathophysiology. Indeed, this tool further enriched the current knowledge on energy metabolism impairment in the DXR-induced cardiotoxic cascade.


The capability of FDG to selectively track the early endoplasmic reticulum pentose phosphate pathway (PPP) response to oxidative stress rather than the later occurring contractile dysfunction might imply the abrupt occurrence of metabolic abnormality during the course of chemotherapy, possibly identifying the ongoing myocardial damage in time to change the chemotherapy scheme or to initiate targeted cardioprotective treatments. Future prospective studies encompassing a specific dietary or pharmacologic preparation before FDG injection, as already performed in infectious and inflammatory heart diseases, are needed to move the obtained preclinical findings supporting the role of FDG imaging in DXR cardiotoxicity from bench to bedside.


Cardiotoxicity Fluorodeoxyglucose Positron emission tomography Doxorubicin Oxidative stress 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Nuclear Medicine UnitIRCCS Ospedale Policlinico San MartinoGenoaItaly
  2. 2.Department of Health Sciences (DISSAL)University of GenovaGenoaItaly
  3. 3.CNR Institute of Molecular Bioimaging and PhysiologyMilanItaly

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