Novel imaging paradigms for characterization of cardiovascular toxicities associated with cancer therapy

Figures

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  Fig. 1. Myocardial strain using MRI techniques. In this figure, MRI measures of global longitudinal and circumferential strain are derived using strain encoding (SENC, top) and post-processing of cine images with feature tracking (bottom) in the same 2 patients, A and B. Feature tracking quantifies myocardial deformation through an algorithm that identifies images features in the myocardium that can be reliably identified and tracked on a frame-by-frame basis throughout the cardiac cycle. SENC differs from feature tracking in that it measures strain in the direction perpendicular to the imaging plane: circumferential from the long-axis and longitudinal from the short-axis images. MRI = magnetic resonance imaging, SENC = strain encoding, GLS = global longitudinal strain, GCS = global circumferential strain. Image modified and used without restriction under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/). Original source: Early, J et al. [9]

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  Fig. 2. Use of cardiac MRI in cardio-oncology. Some cardiac MRI parameters such as T2 Stir and late gadolinium enhancement, could be harnessed to detect inflammation, edema and necrosis or fibrosis often associated with the diagnosis of other forms of cardiotoxicity such as immune-checkpoint inhibitor myocarditis. These images, obtained in a patient treated with nivolumab, demonstrate increased signal on T2 Stir (panel A, black asterisk) and late gadolinium enhancement (panel B, white arrow) consistent with immune checkpoint myocarditis.