TARGET AUDIENCE – Cardiologist, Radiologist, Oncologist and MR physicist OUTCOME/OBJECTIVES – I would like to discuss some of the promising applications of magnetic resonance imaging (MRI) in oncocardiology field. PURPOSE – Current guidelines consider LVEF assessment using echocardiography as the standard diagnostic technique for detecting chemotherapy-induced cardiotoxicity [1, 2]. However, magnetic resonance imaging (MRI) may play an important role in the cardiac evaluation of cancer patients [3-5]. MRI is the gold standard for the evaluation of ventricular volumes and function, with greater intra- and inter-observer reproducibility compared with other modalities, and may achieve higher sensitivity in identifying cardiomyopathy compared with other diagnostic techniques [6, 7]. The objective of our proposed studies is to investigate the use of cardiac MRI to evaluate early tissue changes and perform functional assessment in chemo- and radiation-induced cardiotoxicity.
METHODS – We have done a few animal studies to evaluate MRI and tissue changes in cardiotoxicity rat and rabbit models. In our center, a single- center, large-scale prospective study is now in progress. Cardiac imaging protocol will be added to diagnose cardiotoxicity in breast cancer patients. The cardiac imaging protocol includes T1 and T2 mapping sequences and cine imaging of the left ventricular (LV) myocardium. We will analyze left ventricular (LV) volume and ejection fraction (EF), myocardial native T1, extracellular volume fraction (ECV), and T2 values acquired in the mid ventricle.
EXPECTED RESULTS – In the early phase of exposure to anthracycline agent, tissue injury and concurrent elevation of native T1 and ECV values were noted in the preclinical animal study, without significant LV reduction [8]. Therefore, T1 mapping MRI allows earlier detection of chemotherapy-induced cardiotoxicity. MRI would be useful in the early detection and risk stratification of chemotherapy- and radiation therapy-induced cardiotoxicity in clinical field.
DISCUSSION – Recently, significant attention has been focused on the field of oncocardiology. In 2016, a clinical guideline for cardiovascular toxicity was developed by the European Society of Cardiology. Many cancer therapies cause heart problems. These cancer therapies include chemotherapy, target agents, mediastinal irradiations. These therapies cause LV dysfunction, hypertension and other conditions such as arrythmias, coronary artery diseases, and thrombus formation and HF from cancer therapy has worse prognosis the idiopathic cardiomyopathy [9, 10]. The previous study proved that early diagnosis and prompt treatment are vital for a better diagnosis. In this study, more than 90% of cases within within 1 year of initiating chemotherapy. Early treated group showed better prognosis than the other group [11, 12]. In this context, I would like to discuss some of the promising applications of magnetic resonance imaging (MRI) in oncocardiology. The main strength of cardiac MRI is tissue characterization. MRI would be useful in the field of oncocardiology.

Acknowledgements

This work was supported by the National Research Foundation of Korea (grant NRF-2017R1A2B4009661) and by the Basic Science Research Program through the National Research Foundation of Korea, funded by the Ministry of Science, Information and Communication Technology, and Future Planning (grant NRF-2014R1A1A3050905)