Cardiovascular Magnetic Resonance Relaxometry in Early Detection of Anthracycline Cardiotoxicity
Purpose of the Review
To provide an overview of the published data on the value of cardiovascular magnetic resonance (CMR) based T1 and T2 and extracellular volume (ECV) fraction quantification to identify myocardial abnormalities related to anthracycline treatment in patients with cancer.
In animal models of anthracycline cardiotoxicity, elevations in myocardial T1 and T2 values appear to occur early during treatment followed by ventricular remodeling, persistent elevation in T1, and increase in ECV. These findings suggest early myocardial inflammation/edema followed by myocardial fibrosis and ventricular dysfunction. Similarly in patients receiving cancer therapy, T1 and ECV values increase early after anthracycline therapy. The value of T2 mapping in this setting has not been established. Likewise, adult cancer survivors with or without LV dysfunction have increased ECV values which may be associated with worse diastolic parameters. The value of ECV to identify subclinical cardiomyopathy in pediatric cancer survivors remains controversial.
Quantitative CMR tissue characterization techniques may have a unique role in identifying the pathophysiology of anthracycline-induced cardiomyopathy and for early detection of myocardial injury. In cancer survivors, these techniques have a potential role in identifying early and subclinical myocardial injury. However, the overall literature on quantitative CMR tissue characterization techniques to detect anthracycline cardiotoxicity is limited.
KeywordsCardiovascular magnetic resonance T1 mapping T2 mapping ECV Cardiotoxicity Anthracyclines
Compliance with Ethical Standards
Conflict of Interest
All authors declare 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
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