CMR imaging biosignature of cardiac involvement due to cancer-related treatment by T1 and T2 mapping

Haslbauer, Jasmin D.; Lindner, Sarah; Valbuena-López, Silvia; Zainal, H.A.; Zhou, Hui; D’Angelo, Tommaso; Pathan, Faraz; Arendt, C; Bug, Gesine; Serve, Hubert; Vogl, Thomas J.; Zeiher, Andreas M.; Carr‐White, Gerry; Nagel, Eike; Püntmann, Valentina O.

doi:10.1016/j.ijcard.2018.10.023

Cited by 63 publications

(46 citation statements)

References 43 publications

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“…T 2 maps are obtained by acquiring multiple images with different sensitivities to T 2 . This is commonly performed by collecting spin‐echo images with varying echo times, which yields a T 2 decay curve . Data fitting is performed on the T 2 decay curve and the T 2 relaxation time for each voxel can be measured.…”

Section: Cardiac Mri Methods and Principlesmentioning

confidence: 99%

“…This is commonly performed by collecting spin-echo images with varying echo times, which yields a T 2 decay curve. 22 Data fitting is performed on the T 2 decay curve and the T 2 relaxation time for each voxel can be measured. Both dark-blood turbo spin echo (TSE) and bright-blood T 2 magnetization-preparation (T 2 -prep)-based pulse sequences have been utilized for cardiac T 2 mapping applications.…”

Section: Cardiac Mri Methods and Principlesmentioning

confidence: 99%

“…While previously MRI could be used to assess edema through several methods, including myocardial early gadolinium enhancement ratio on standard dark blood fast / turbo spin echo (FSE/TSE) sequences, T 2 short‐TI inversion recovery (T 2 ‐STIR) imaging, and acquisition for cardiac unified T 2 edema (ACUT 2 E) TSE‐SSFP hybrid imaging sequences, T 2 mapping provides quantification of T 2 values of each voxel and more consistent diagnosis with less susceptibility to artifacts . Research by Haslbauer et al, who evaluated patients within 3 months or after 12 months of cancer‐related treatment, suggested increased native T 1 and T 2 values detected early myocardial inflammation, while elevated native T 1 but not T 2 demonstrated later interstitial fibrosis and remodeling …”

Section: Tissue Characterizationmentioning

confidence: 99%

“…79 Research by Haslbauer et al, who evaluated patients within 3 months or after 12 months of cancer-related treatment, suggested increased native T 1 and T 2 values detected early myocardial inflammation, while elevated native T 1 but not T 2 demonstrated later interstitial fibrosis and remodeling. 22 Transforming the current landscape of oncologic treatment, immunotherapy regimens are being intensely studied for the treatment of numerous cancers. Specifically immune checkpoint inhibitors (ICIs), including cytotoxic T-lymphocyte antigen (CTLA-4) and programmed cell death-1 (PD-1) inhibitors, have produced remarkable responses to therapy.…”

Section: Myocardial Fibrosismentioning

confidence: 99%

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MRI in cardio‐oncology: A review of cardiac complications in oncologic care

Jeong

Gladish

Chițiboi

et al. 2019

Magnetic Resonance Imaging

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From detailed characterization of cardiac abnormalities to the assessment of cancer treatment‐related cardiac dysfunction, cardiac MRI is playing a growing role in the evaluation of cardiac pathology in oncology patients. Current guidelines are now incorporating the use of MRI for the comprehensive multidisciplinary approach to cancer management, and innovative applications of MRI in research are expanding its potential to provide a powerful noninvasive tool in the arsenal against cancer. This review focuses on the application of cardiac MRI to diagnose and manage cardiovascular complications related to cancer and its treatment. Following an introduction to current cardiac MRI methods and principles, this review is divided into two sections: functional cardiovascular analysis and anatomical or tissue characterization related to cancer and cancer therapeutics. Level of Evidence: 5 Technical Efficacy Stage: 1 J. Magn. Reson. Imaging 2019;50:1349–1366.

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Section: Cardiac Mri Methods and Principlesmentioning

confidence: 99%

Section: Cardiac Mri Methods and Principlesmentioning

confidence: 99%

Section: Tissue Characterizationmentioning

confidence: 99%

Section: Myocardial Fibrosismentioning

confidence: 99%

See 2 more Smart Citations

MRI in cardio‐oncology: A review of cardiac complications in oncologic care

Jeong

Gladish

Chițiboi

et al. 2019

Magnetic Resonance Imaging

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“…Of note, while CMR is strong in the detection of fat, the diagnosis on the exact tumor often remains unclear. CMR does provide important information on the malignant/benign origin of a mass and helps to define surgical approaches [50].…”

Section: Pericardial Masses and Cmrmentioning

confidence: 99%

CMR in Pericardial Diseases - an Update

Vidalakis

Kolentinis

Gawor

et al. 2020

Curr Cardiovasc Imaging Rep

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Purpose of Review To review the latest developments and the current role of the cardiac magnetic resonance (CMR) in pericardial diseases and their complications. Recent Findings Cardiac Magnetic Resonance (CMR) has the ability to incorporate anatomy, physiology, and "virtual histology" strategies to achieve the most accurate diagnosis for even the most demanding, pericardial diseases. Summary Acute, chronic, recurrent, and constrictive pericarditis as well as pericarditis related complications, pericardial masses and congenital pericardial defects are commonly encountered in clinical practice with relatively significant morbidity and mortality. Owing to the challenging diagnosis, CMR imaging is often employed in confirming the diagnosis and elucidating the underling pathophysiology. In this review we outline the common CMR techniques and their expected diagnostic outcomes.

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Comprehensive Cardiovascular Magnetic Resonance Tissue Characterization and Cardiotoxicity in Women With Breast Cancer

et al. 2023

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ImportanceThere is a growing interest in understanding whether cardiovascular magnetic resonance (CMR) myocardial tissue characterization helps identify risk of cancer therapy–related cardiac dysfunction (CTRCD).ObjectiveTo describe changes in CMR tissue biomarkers during breast cancer therapy and their association with CTRCD.Design, Setting, and ParticipantsThis was a prospective, multicenter, cohort study of women with ERBB2 (formerly HER2)–positive breast cancer (stages I-III) who were scheduled to receive anthracycline and trastuzumab therapy with/without adjuvant radiotherapy and surgery. From November 7, 2013, to January 16, 2019, participants were recruited from 3 University of Toronto–affiliated hospitals. Data were analyzed from July 2021 to June 2022.ExposuresSequential therapy with anthracyclines, trastuzumab, and radiation.Main Outcomes and MeasuresCMR, high-sensitivity cardiac troponin I (hs-cTnI), and B-type natriuretic peptide (BNP) measurements were performed before anthracycline treatment, after anthracycline and before trastuzumab treatment, and at 3-month intervals during trastuzumab therapy. CMR included left ventricular (LV) volumes, LV ejection fraction (EF), myocardial strain, early gadolinium enhancement imaging to assess hyperemia (inflammation marker), native/postcontrast T1 mapping (with extracellular volume fraction [ECV]) to assess edema and/or fibrosis, T2 mapping to assess edema, and late gadolinium enhancement (LGE) to assess replacement fibrosis. CTRCD was defined using the Cardiac Review and Evaluation Committee criteria. Fixed-effects models or generalized estimating equations were used in analyses.ResultsOf 136 women (mean [SD] age, 51.1 [9.2] years) recruited from 2013 to 2019, 37 (27%) developed CTRCD. Compared with baseline, tissue biomarkers of myocardial hyperemia and edema peaked after anthracycline therapy or 3 months after trastuzumab initiation as demonstrated by an increase in mean (SD) relative myocardial enhancement (baseline, 46.3% [16.8%] to peak, 56.2% [18.6%]), native T1 (1012 [26] milliseconds to 1035 [28] milliseconds), T2 (51.4 [2.2] milliseconds to 52.6 [2.2] milliseconds), and ECV (25.2% [2.4%] to 26.8% [2.7%]), with P &lt;.001 for the entire follow-up. The observed values were mostly within the normal range, and the changes were small and recovered during follow-up. No new replacement fibrosis developed. Increase in T1, T2, and/or ECV was associated with increased ventricular volumes and BNP but not hs-cTnI level. None of the CMR tissue biomarkers were associated with changes in LVEF or myocardial strain. Change in ECV was associated with concurrent and subsequent CTRCD, but there was significant overlap between patients with and without CTRCD.Conclusions and RelevanceIn women with ERBB2-positive breast cancer receiving sequential anthracycline and trastuzumab therapy, CMR tissue biomarkers suggest inflammation and edema peaking early during therapy and were associated with ventricular remodeling and BNP elevation. However, the increases in CMR biomarkers were transient, were not associated with LVEF or myocardial strain, and were not useful in identifying traditional CTRCD risk.

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CMR imaging biosignature of cardiac involvement due to cancer-related treatment by T1 and T2 mapping

Cited by 63 publications

References 43 publications

MRI in cardio‐oncology: A review of cardiac complications in oncologic care

MRI in cardio‐oncology: A review of cardiac complications in oncologic care

CMR in Pericardial Diseases - an Update

Comprehensive Cardiovascular Magnetic Resonance Tissue Characterization and Cardiotoxicity in Women With Breast Cancer

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