Cardiovascular Magnetic Resonance Relaxometry in Early Detection of Anthracycline Cardiotoxicity

  • Camila Urzua Fresno
  • Tamar Shalmon
  • Oscar Calvillo Argüelles
  • Bernd J. Wintersperger
  • Paaladinesh ThavendiranathanEmail author
Cardio-Oncology (J Mitchell, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Cardio-Oncology


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.

Recent Findings

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.


Cardiovascular 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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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2020

Authors and Affiliations

  • Camila Urzua Fresno
    • 1
    • 2
  • Tamar Shalmon
    • 1
  • Oscar Calvillo Argüelles
    • 1
  • Bernd J. Wintersperger
    • 2
    • 3
  • Paaladinesh Thavendiranathan
    • 1
    • 2
    Email author
  1. 1.Division of Cardiology, Peter Munk Cardiac Center, Ted Rogers Program in Cardiotoxicity Prevention and Department of Medical Imaging, University Health NetworkUniversity of TorontoTorontoCanada
  2. 2.Department of Medical Imaging, University Health NetworkUniversity of TorontoTorontoCanada
  3. 3.Department of Medical ImagingUniversity of TorontoTorontoCanada

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