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State-of-the-art CMR Mapping Techniques in the Detection of Subclinical Chemotherapy-induced Cardiotoxicity in Breast Cancer Patients

Received: 23 December 2020     Accepted: 30 December 2020     Published: 15 January 2021
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Abstract

Background: The oncological treatments have improved survival rates but with an increased risk of cardiovascular disease (CVD). Purpose: To detect subclinical cardiotoxic changes using Cardiovascular Magnetic Resonance (CMR) and to define parameters for the prediction of late cardiac changes after 3 months follow-up. Patients and methods: We conducted a prospective study in 21 breast cancer patients who were scheduled to undergo treatment either with anthracyclines, trastuzumab, or docetaxel. CMR scans were performed before therapy onset as well as 3-6 days and 3 months thereafter. Native left ventricular (LV) T1 and T2 parameters were acquired in addition to standard parameters. Results: Compared to baseline, the mean left ventricular ejection fraction (LVEF) tended to mildly decrease during follow-up. A significant reduction in mean native T1 was found from 1246.6 ± 29.5 ms at baseline to 1231.4 ± 31.4 ms at 3-6 days, which was followed by significant increase after 3 months reaching 1265.8 ± 27.9 ms with p = 0.011 and 0.012, respectively. A significant increase in mean T2 was also found from 41.6 ± 3.4 ms at baseline to 43.8 ± 3.8 ms after 3 months with p = 0.045. From 21 patients, only 1 patient (4.8%) experienced cardiotoxicity. Conclusion: Treatment with potentially cardiotoxic drugs is associated with a change of CMR-derived native T1 which may enable an early identification of cardiotoxicity among breast cancer patients.

Published in International Journal of Medical Imaging (Volume 9, Issue 1)
DOI 10.11648/j.ijmi.20210901.13
Page(s) 29-35
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Breast Cancer, Anthracyclines, Trastuzumab, Cardiotoxicity, T1 Mapping, Cardiac MRI

References
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Cite This Article
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    Noura Abdelmonem Atia, Lorenz Lehmann, Mohamed Adel Eltomey, Mohamed Alm El-Din, Johannes Riffel, et al. (2021). State-of-the-art CMR Mapping Techniques in the Detection of Subclinical Chemotherapy-induced Cardiotoxicity in Breast Cancer Patients. International Journal of Medical Imaging, 9(1), 29-35. https://doi.org/10.11648/j.ijmi.20210901.13

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    ACS Style

    Noura Abdelmonem Atia; Lorenz Lehmann; Mohamed Adel Eltomey; Mohamed Alm El-Din; Johannes Riffel, et al. State-of-the-art CMR Mapping Techniques in the Detection of Subclinical Chemotherapy-induced Cardiotoxicity in Breast Cancer Patients. Int. J. Med. Imaging 2021, 9(1), 29-35. doi: 10.11648/j.ijmi.20210901.13

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    AMA Style

    Noura Abdelmonem Atia, Lorenz Lehmann, Mohamed Adel Eltomey, Mohamed Alm El-Din, Johannes Riffel, et al. State-of-the-art CMR Mapping Techniques in the Detection of Subclinical Chemotherapy-induced Cardiotoxicity in Breast Cancer Patients. Int J Med Imaging. 2021;9(1):29-35. doi: 10.11648/j.ijmi.20210901.13

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  • @article{10.11648/j.ijmi.20210901.13,
      author = {Noura Abdelmonem Atia and Lorenz Lehmann and Mohamed Adel Eltomey and Mohamed Alm El-Din and Johannes Riffel and Constantin Dreher and Philipp Bäumer and Anoshirwan Andrej Tavakoli and Norbert Frey and Heinz-Peter Schlemmer and Matthias Friedrich and Mahmoud Abdelaziz Dawoud},
      title = {State-of-the-art CMR Mapping Techniques in the Detection of Subclinical Chemotherapy-induced Cardiotoxicity in Breast Cancer Patients},
      journal = {International Journal of Medical Imaging},
      volume = {9},
      number = {1},
      pages = {29-35},
      doi = {10.11648/j.ijmi.20210901.13},
      url = {https://doi.org/10.11648/j.ijmi.20210901.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmi.20210901.13},
      abstract = {Background: The oncological treatments have improved survival rates but with an increased risk of cardiovascular disease (CVD). Purpose: To detect subclinical cardiotoxic changes using Cardiovascular Magnetic Resonance (CMR) and to define parameters for the prediction of late cardiac changes after 3 months follow-up. Patients and methods: We conducted a prospective study in 21 breast cancer patients who were scheduled to undergo treatment either with anthracyclines, trastuzumab, or docetaxel. CMR scans were performed before therapy onset as well as 3-6 days and 3 months thereafter. Native left ventricular (LV) T1 and T2 parameters were acquired in addition to standard parameters. Results: Compared to baseline, the mean left ventricular ejection fraction (LVEF) tended to mildly decrease during follow-up. A significant reduction in mean native T1 was found from 1246.6 ± 29.5 ms at baseline to 1231.4 ± 31.4 ms at 3-6 days, which was followed by significant increase after 3 months reaching 1265.8 ± 27.9 ms with p = 0.011 and 0.012, respectively. A significant increase in mean T2 was also found from 41.6 ± 3.4 ms at baseline to 43.8 ± 3.8 ms after 3 months with p = 0.045. From 21 patients, only 1 patient (4.8%) experienced cardiotoxicity. Conclusion: Treatment with potentially cardiotoxic drugs is associated with a change of CMR-derived native T1 which may enable an early identification of cardiotoxicity among breast cancer patients.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - State-of-the-art CMR Mapping Techniques in the Detection of Subclinical Chemotherapy-induced Cardiotoxicity in Breast Cancer Patients
    AU  - Noura Abdelmonem Atia
    AU  - Lorenz Lehmann
    AU  - Mohamed Adel Eltomey
    AU  - Mohamed Alm El-Din
    AU  - Johannes Riffel
    AU  - Constantin Dreher
    AU  - Philipp Bäumer
    AU  - Anoshirwan Andrej Tavakoli
    AU  - Norbert Frey
    AU  - Heinz-Peter Schlemmer
    AU  - Matthias Friedrich
    AU  - Mahmoud Abdelaziz Dawoud
    Y1  - 2021/01/15
    PY  - 2021
    N1  - https://doi.org/10.11648/j.ijmi.20210901.13
    DO  - 10.11648/j.ijmi.20210901.13
    T2  - International Journal of Medical Imaging
    JF  - International Journal of Medical Imaging
    JO  - International Journal of Medical Imaging
    SP  - 29
    EP  - 35
    PB  - Science Publishing Group
    SN  - 2330-832X
    UR  - https://doi.org/10.11648/j.ijmi.20210901.13
    AB  - Background: The oncological treatments have improved survival rates but with an increased risk of cardiovascular disease (CVD). Purpose: To detect subclinical cardiotoxic changes using Cardiovascular Magnetic Resonance (CMR) and to define parameters for the prediction of late cardiac changes after 3 months follow-up. Patients and methods: We conducted a prospective study in 21 breast cancer patients who were scheduled to undergo treatment either with anthracyclines, trastuzumab, or docetaxel. CMR scans were performed before therapy onset as well as 3-6 days and 3 months thereafter. Native left ventricular (LV) T1 and T2 parameters were acquired in addition to standard parameters. Results: Compared to baseline, the mean left ventricular ejection fraction (LVEF) tended to mildly decrease during follow-up. A significant reduction in mean native T1 was found from 1246.6 ± 29.5 ms at baseline to 1231.4 ± 31.4 ms at 3-6 days, which was followed by significant increase after 3 months reaching 1265.8 ± 27.9 ms with p = 0.011 and 0.012, respectively. A significant increase in mean T2 was also found from 41.6 ± 3.4 ms at baseline to 43.8 ± 3.8 ms after 3 months with p = 0.045. From 21 patients, only 1 patient (4.8%) experienced cardiotoxicity. Conclusion: Treatment with potentially cardiotoxic drugs is associated with a change of CMR-derived native T1 which may enable an early identification of cardiotoxicity among breast cancer patients.
    VL  - 9
    IS  - 1
    ER  - 

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Author Information
  • Department of Diagnostic Radiology, Faculty of Medicine, Tanta University, Tanta, Egypt

  • DepaDZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg/Mannheim, Heidelberg, Germanyrtment of Cardiology, Heidelberg University Hospital, Heidelberg, Germany

  • Department of Diagnostic Radiology, Faculty of Medicine, Tanta University, Tanta, Egypt

  • Department of Clinical Oncology, Faculty of Medicine, Tanta University, Tanta, Egypt

  • Department of Cardiology, Heidelberg University Hospital, Heidelberg, Germany

  • Department of Radiation Oncology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

  • DKFZ (German Cancer Research Center), Department of Radiology, Heidelberg, Germany

  • Department of Cardiology, Heidelberg University Hospital, Heidelberg, Germany

  • DKFZ (German Cancer Research Center), Department of Radiology, Heidelberg, Germany

  • Department of Cardiology, Heidelberg University Hospital, Heidelberg, Germany

  • Department of Diagnostic Radiology, Faculty of Medicine, Tanta University, Tanta, Egypt

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