Acute lymphoblastic leukemia echocardiography and ultrasound: Difference between revisions
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{{Acute lymphoblastic leukemia}} | {{Acute lymphoblastic leukemia}} | ||
{{CMG}} {{shyam}} | {{CMG}} {{AE}}{{shyam}} | ||
==Overview== | ==Overview== | ||
Additional imaging studies that can be useful in acute lymphoblastic leukemia include echocardiogram and ultrasound. Echocardiogram is useful for assessing cardiac function in patients receiving anthracycline chemotherapy. Ultrasound is useful for assessing for deep vein thrombosis which is a common complication of acute lymphoblastic leukemia. Ultrasound can also assess for spleen size. | Additional imaging studies that can be useful in acute lymphoblastic leukemia include [[echocardiogram]] and [[ultrasound]]. [[Echocardiogram]] is useful for assessing [[cardiac]] function in patients receiving [[anthracycline]] [[chemotherapy]]. [[Ultrasound]] is useful for assessing for [[deep vein thrombosis]] which is a common complication of acute lymphoblastic leukemia. [[Ultrasound]] can also assess for [[spleen]] size. | ||
==Echocardiograph and ultrasound== | ==Echocardiograph and ultrasound== | ||
===Echocardiograph=== | ===Echocardiograph=== | ||
*An echocardiogram is an essential imaging modality in patients with acute lymphoblastic leukemia receiving anthracycline chemotherapy.<ref name="pmid22917553">{{cite journal| author=Neilan TG, Coelho-Filho OR, Pena-Herrera D, Shah RV, Jerosch-Herold M, Francis SA et al.| title=Left ventricular mass in patients with a cardiomyopathy after treatment with anthracyclines. | journal=Am J Cardiol | year= 2012 | volume= 110 | issue= 11 | pages= 1679-86 | pmid=22917553 | doi=10.1016/j.amjcard.2012.07.040 | pmc=3496816 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22917553 }} </ref> | *An [[echocardiogram]] is an essential imaging modality in patients with acute lymphoblastic leukemia receiving [[anthracycline]] [[chemotherapy]].<ref name="pmid22917553">{{cite journal| author=Neilan TG, Coelho-Filho OR, Pena-Herrera D, Shah RV, Jerosch-Herold M, Francis SA et al.| title=Left ventricular mass in patients with a cardiomyopathy after treatment with anthracyclines. | journal=Am J Cardiol | year= 2012 | volume= 110 | issue= 11 | pages= 1679-86 | pmid=22917553 | doi=10.1016/j.amjcard.2012.07.040 | pmc=3496816 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22917553 }} </ref> | ||
*Patients who will be receiving anthracycline-based therapy require a baseline echocardiogram to assess the ejection fraction prior to therapy<ref name="pmid25605569">{{cite journal| author=Mina A, Rafei H, Khalil M, Hassoun Y, Nasser Z, Tfayli A| title=Role of baseline echocardiography prior to initiation of anthracycline-based chemotherapy in breast cancer patients. | journal=BMC Cancer | year= 2015 | volume= 15 | issue= | pages= 10 | pmid=25605569 | doi=10.1186/s12885-014-1004-0 | pmc=4311428 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25605569 }} </ref> | *Patients who will be receiving [[anthracycline]]-based therapy require a baseline [[echocardiogram]] to assess the [[ejection fraction]] prior to therapy<ref name="pmid25605569">{{cite journal| author=Mina A, Rafei H, Khalil M, Hassoun Y, Nasser Z, Tfayli A| title=Role of baseline echocardiography prior to initiation of anthracycline-based chemotherapy in breast cancer patients. | journal=BMC Cancer | year= 2015 | volume= 15 | issue= | pages= 10 | pmid=25605569 | doi=10.1186/s12885-014-1004-0 | pmc=4311428 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25605569 }} </ref> | ||
*Anthracyclines are known to cause cardiac toxicity (specifically cardiomyopathy with cumulative anthracycline doses above 500mg/m2)<ref name="pmid28185035">{{cite journal| author=McGowan JV, Chung R, Maulik A, Piotrowska I, Walker JM, Yellon DM| title=Anthracycline Chemotherapy and Cardiotoxicity. | journal=Cardiovasc Drugs Ther | year= 2017 | volume= 31 | issue= 1 | pages= 63-75 | pmid=28185035 | doi=10.1007/s10557-016-6711-0 | pmc=5346598 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28185035 }} </ref> | *[[Anthracyclines]] are known to cause [[Cardiotoxicity|cardiac toxicity]] (specifically [[cardiomyopathy]] with cumulative [[anthracycline]] doses above 500mg/m2)<ref name="pmid28185035">{{cite journal| author=McGowan JV, Chung R, Maulik A, Piotrowska I, Walker JM, Yellon DM| title=Anthracycline Chemotherapy and Cardiotoxicity. | journal=Cardiovasc Drugs Ther | year= 2017 | volume= 31 | issue= 1 | pages= 63-75 | pmid=28185035 | doi=10.1007/s10557-016-6711-0 | pmc=5346598 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28185035 }} </ref> | ||
*An echocardiogram should be obtained every three months while on therapy with anthracycline. | *An [[echocardiogram]] should be obtained every three months while on therapy with [[anthracycline]]. | ||
===Ultrasound=== | ===Ultrasound=== | ||
*This is useful for diagnosis of lower extremity thrombosis, which commonly occurs in patients with acute lymphoblastic leukemia.<ref name="pmid26973753">{{cite journal| author=Zitek T, Baydoun J, Yepez S, Forred W, Slattery DE| title=Mistakes and Pitfalls Associated with Two-Point Compression Ultrasound for Deep Vein Thrombosis. | journal=West J Emerg Med | year= 2016 | volume= 17 | issue= 2 | pages= 201-8 | pmid=26973753 | doi=10.5811/westjem.2016.1.29335 | pmc=4786247 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26973753 }} </ref> | *This is useful for [[diagnosis]] of lower extremity [[thrombosis]], which commonly occurs in patients with acute lymphoblastic leukemia.<ref name="pmid26973753">{{cite journal| author=Zitek T, Baydoun J, Yepez S, Forred W, Slattery DE| title=Mistakes and Pitfalls Associated with Two-Point Compression Ultrasound for Deep Vein Thrombosis. | journal=West J Emerg Med | year= 2016 | volume= 17 | issue= 2 | pages= 201-8 | pmid=26973753 | doi=10.5811/westjem.2016.1.29335 | pmc=4786247 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26973753 }} </ref> | ||
*Ultrasound can also assess for splenomegaly, which occurs in patients with acute lymphoblastic leukemia as a result of leukemic infiltration or extramedullary hematopoiesis<ref name="pmid22096219">{{cite journal| author=Saboo SS, Krajewski KM, O'Regan KN, Giardino A, Brown JR, Ramaiya N et al.| title=Spleen in haematological malignancies: spectrum of imaging findings. | journal=Br J Radiol | year= 2012 | volume= 85 | issue= 1009 | pages= 81-92 | pmid=22096219 | doi=10.1259/bjr/31542964 | pmc=3473934 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22096219 }} </ref> | *[[Ultrasound]] can also assess for [[splenomegaly]], which occurs in patients with acute lymphoblastic leukemia as a result of leukemic infiltration or [[extramedullary hematopoiesis]]<ref name="pmid22096219">{{cite journal| author=Saboo SS, Krajewski KM, O'Regan KN, Giardino A, Brown JR, Ramaiya N et al.| title=Spleen in haematological malignancies: spectrum of imaging findings. | journal=Br J Radiol | year= 2012 | volume= 85 | issue= 1009 | pages= 81-92 | pmid=22096219 | doi=10.1259/bjr/31542964 | pmc=3473934 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22096219 }} </ref> | ||
[[image:Splenomegaly-1.JPG|thumb|350px|Splenomegaly ultrasonography-Case courtesy of Dr Ian Bickle, via radiopaedia.org<ref name="https://radiopaedia.org/">Radiopaedia.org. From the case <"https://radiopaedia.org/cases/52825">rID: 52825</ref>|center]]<br style="clear:left" /> | |||
[[File:Dvt.JPG|400 px|thumb|Acute common femoral vein thrombosis[https://radiopaedia.org/cases/deep-venous-thrombosis?lang=usCase courtesy of Dr Jose Miguel Terrazas Najera, Radiopaedia.org, rID: 26439]|center]]<br style="clear:left" /> | |||
<br style="clear:left" /> | |||
==References== | ==References== | ||
Latest revision as of 16:06, 29 October 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shyam Patel [2]
Overview
Additional imaging studies that can be useful in acute lymphoblastic leukemia include echocardiogram and ultrasound. Echocardiogram is useful for assessing cardiac function in patients receiving anthracycline chemotherapy. Ultrasound is useful for assessing for deep vein thrombosis which is a common complication of acute lymphoblastic leukemia. Ultrasound can also assess for spleen size.
Echocardiograph and ultrasound
Echocardiograph
- An echocardiogram is an essential imaging modality in patients with acute lymphoblastic leukemia receiving anthracycline chemotherapy.[1]
- Patients who will be receiving anthracycline-based therapy require a baseline echocardiogram to assess the ejection fraction prior to therapy[2]
- Anthracyclines are known to cause cardiac toxicity (specifically cardiomyopathy with cumulative anthracycline doses above 500mg/m2)[3]
- An echocardiogram should be obtained every three months while on therapy with anthracycline.
Ultrasound
- This is useful for diagnosis of lower extremity thrombosis, which commonly occurs in patients with acute lymphoblastic leukemia.[4]
- Ultrasound can also assess for splenomegaly, which occurs in patients with acute lymphoblastic leukemia as a result of leukemic infiltration or extramedullary hematopoiesis[5]
References
- ↑ Neilan TG, Coelho-Filho OR, Pena-Herrera D, Shah RV, Jerosch-Herold M, Francis SA; et al. (2012). "Left ventricular mass in patients with a cardiomyopathy after treatment with anthracyclines". Am J Cardiol. 110 (11): 1679–86. doi:10.1016/j.amjcard.2012.07.040. PMC 3496816. PMID 22917553.
- ↑ Mina A, Rafei H, Khalil M, Hassoun Y, Nasser Z, Tfayli A (2015). "Role of baseline echocardiography prior to initiation of anthracycline-based chemotherapy in breast cancer patients". BMC Cancer. 15: 10. doi:10.1186/s12885-014-1004-0. PMC 4311428. PMID 25605569.
- ↑ McGowan JV, Chung R, Maulik A, Piotrowska I, Walker JM, Yellon DM (2017). "Anthracycline Chemotherapy and Cardiotoxicity". Cardiovasc Drugs Ther. 31 (1): 63–75. doi:10.1007/s10557-016-6711-0. PMC 5346598. PMID 28185035.
- ↑ Zitek T, Baydoun J, Yepez S, Forred W, Slattery DE (2016). "Mistakes and Pitfalls Associated with Two-Point Compression Ultrasound for Deep Vein Thrombosis". West J Emerg Med. 17 (2): 201–8. doi:10.5811/westjem.2016.1.29335. PMC 4786247. PMID 26973753.
- ↑ Saboo SS, Krajewski KM, O'Regan KN, Giardino A, Brown JR, Ramaiya N; et al. (2012). "Spleen in haematological malignancies: spectrum of imaging findings". Br J Radiol. 85 (1009): 81–92. doi:10.1259/bjr/31542964. PMC 3473934. PMID 22096219.
- ↑ Radiopaedia.org. From the case <"https://radiopaedia.org/cases/52825">rID: 52825