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April 5, 2022Journal of ImagingOpen Access

Cardiac Magnetic Resonance Imaging in Immune Check-Point Inhibitor Myocarditis: A Systematic Review

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Key result

Cardiac magnetic resonance imaging in ICI-myocarditis revealed mostly preserved LVEF, edema (9-60%), and LGE (23-83%), with native T1 mapping showing higher concordance with endomyocardial biopsy.

Why the study?

Several studies have investigated CMR in patients with ICI-myocarditis, but the available evidence on CMR findings had not been systematically summarized.

What are the characteristic cardiac magnetic resonance imaging findings and their prognostic value in patients with immune checkpoint inhibitor myocarditis?

Population

166 patients from five cohorts, plus 86 patients from a sub-analysis, with ICI-M across six studies

Design

Systematic review

Authors

LALuca ArcariGTGiacomo TiniGCGiovanni Camastra

Discussion

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Member takes

Overview

Preserved LVEF does not exclude ICI-myocarditis; extends CMR diagnostic criteria and supports native T1 validation.

Study Design

Type

Systematic Review (n=252)

Structured PICO

What are the characteristic cardiac magnetic resonance imaging findings and their prognostic value in patients with immune checkpoint inhibitor myocarditis?

P
Population
Systematic review of 6 studies comprising 252 patients with immune checkpoint inhibitor myocarditis evaluated with cardiac magnetic resonance imaging.
E
Exposure
Cardiac magnetic resonance (CMR) imaging, including T1 and T2 mapping
O
Outcome
CMR findings including left ventricular ejection fraction (LVEF), edema prevalence, and late gadolinium enhancement (LGE) prevalencesurrogate

CMR in immune checkpoint inhibitor myocarditis demonstrates myocardial dysfunction, edema, and fibrosis, with native T1 mapping offering high concordance with biopsy and significant prognostic value.

Limitations

  • Prognostic assessment was inconsistently assessed

Cite This Study

Arcari et al. (2022) conducted a systematic review in Immune Check-Point Inhibitor Myocarditis (n=252). Cardiac magnetic resonance (CMR) imaging vs. Endomyocardial biopsy was evaluated on CMR findings including LVEF, edema, late gadolinium enhancement (LGE), and T1/T2 mapping. Cardiac magnetic resonance imaging in ICI-myocarditis revealed mostly preserved LVEF, edema (9-60%), and LGE (23-83%), with native T1 mapping showing higher concordance with endomyocardial biopsy.

synapsesocial.com/papers/6a61ecbbce9bb37a6d7d9b32https://doi.org/10.3390/jimaging8040099
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Also Consider

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  1. 1Immune Checkpoint Inhibitor Myocarditis With Normal Cardiac Magnetic Resonance Imaging: Importance of Cardiac Biopsy and Early Diagnosis2020 · 14 citations
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