Multimodality imaging features of dasatinib-induced pulmonary arterial hypertension
- 1Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
- 2Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
Abstract
Dasatinib, a tyrosine kinase inhibitor used to treat chronic myelogenous leukemia, is associated with drug-induced pulmonary arterial hypertension (PAH). We report two cases of dasatinib-induced PAH evaluated using advanced noninvasive multimodality imaging. A comprehensive pulmonary hypertension-targeted computed tomography (CT) protocol showed no structural lung abnormalities or pulmonary embolism. However, CT pulmonary perfusion imaging revealed diffuse heterogeneous hypoperfusion in both lungs, suggesting functional pulmonary circulatory impairment. Myocardial delayed-enhancement CT demonstrated late iodine enhancement and increased extracellular volume at the right ventricular insertion points, indicating myocardial involvement related to right ventricular pressure overload. Cardiac magnetic resonance confirmed right ventricular remodeling, and right heart catheterization (RHC) established precapillary pulmonary hypertension. After discontinuation of dasatinib and initiation of pulmonary vasodilator therapy, one patient achieved partial remission and the other normalization of pulmonary hemodynamics on follow-up RHC. These findings underscore the clinical value of advanced imaging in diagnosing and characterizing drug-induced PAH.
Learning objective: To understand the clinical significance of noninvasive multimodality imaging, including a comprehensive pulmonary hypertension-targeted computed tomography protocol, in dasatinib-induced pulmonary arterial hypertension and to integrate imaging findings for a systematic assessment of its pathophysiology and clinical presentation.
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BibTeX
@article{awazu2026multimodality,
title = {{Multimodality imaging features of dasatinib-induced pulmonary arterial hypertension}},
author = {Chikako Awazu and Seitaro Oda and Seika Furuie and Ryo Shinohara and Hidetaka Hayashi and Masafumi Kidoh and Kyoko Hirakawa and Naoto Kuyama and Eiichiro Yamamoto and Yasuhiro Izumiya and Kenichi Tsujita and Toshinori Hirai},
journal = {Journal of Cardiology Cases},
year = {2026},
month = aug,
doi = {10.1016/j.jccase.2026.07.019},
url = {https://doi.org/10.1016/j.jccase.2026.07.019},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Multimodality imaging features of dasatinib-induced pulmonary arterial hypertension
AU - Chikako Awazu
AU - Seitaro Oda
AU - Seika Furuie
AU - Ryo Shinohara
AU - Hidetaka Hayashi
AU - Masafumi Kidoh
AU - Kyoko Hirakawa
AU - Naoto Kuyama
AU - Eiichiro Yamamoto
AU - Yasuhiro Izumiya
AU - Kenichi Tsujita
AU - Toshinori Hirai
PY - 2026
DA - 2026/08/18
JO - Journal of Cardiology Cases
DO - 10.1016/j.jccase.2026.07.019
UR - https://doi.org/10.1016/j.jccase.2026.07.019
AB - Dasatinib, a tyrosine kinase inhibitor used to treat chronic myelogenous leukemia, is associated with drug-induced pulmonary arterial hypertension (PAH). We report two cases of dasatinib-induced PAH evaluated using advanced noninvasive multimodality imaging. A comprehensive pulmonary hypertension-targeted computed tomography (CT) protocol showed no structural lung abnormalities or pulmonary embolism. However, CT pulmonary perfusion imaging revealed diffuse heterogeneous hypoperfusion in both lungs, suggesting functional pulmonary circulatory impairment. Myocardial delayed-enhancement CT demonstrated late iodine enhancement and increased extracellular volume at the right ventricular insertion points, indicating myocardial involvement related to right ventricular pressure overload. Cardiac magnetic resonance confirmed right ventricular remodeling, and right heart catheterization (RHC) established precapillary pulmonary hypertension. After discontinuation of dasatinib and initiation of pulmonary vasodilator therapy, one patient achieved partial remission and the other normalization of pulmonary hemodynamics on follow-up RHC. These findings underscore the clinical value of advanced imaging in diagnosing and characterizing drug-induced PAH. Learning objective: To understand the clinical significance of noninvasive multimodality imaging, including a comprehensive pulmonary hypertension-targeted computed tomography protocol, in dasatinib-induced pulmonary arterial hypertension and to integrate imaging findings for a systematic assessment of its pathophysiology and clinical presentation.
SN - 1878-5409
ER -