MRI in cardio oncology: a two years’ experience, preliminary results

Abstract

Cardio oncology is a new subspecialty, already counting three years of massive expansion following the amazing improvements in the field of cancer treatments.

Imaging is the key part in the diagnosis and follow up of the oncologic patient.

The role of MRI in cardiac imaging is well-known and established. MRI is the gold standard for functional analysis but also the only method providing a non-invasive tissue characterization.

The impact of anthracycline therapy in the heart is well known. Long term myocardial fibrosis and left ventricular functional impairment appears to be irreversible and heart failure difficult to respond to treatment if it is diagnosed in a late stage. Early detection can alter and improve patient’s prognosis.

Immune check -point inhibitors [ICI] induced myocarditis is a life-threatening complication, which requires early diagnosis and urgent treatment.

Sometimes clinical signs and biomarkers are not sufficient to provide a definite diagnosis.

Primary cancers of the chest or heart, direct invasion of the heart or metastasis in the myocardial muscle need an accurate diagnosis.

MRI can be the key imaging modality for risk assessment, diagnosis and follow up of cardiotoxicity related to treatment, and in oncologic patients with types of cancers affecting the heart, primarily or secondary.

The established T2 weighted images can detect myocardial oedema, the use of Late Gadolinium Enhancement sequences and recently the use of mapping can offer an intrinsic view of the changes in the myocardial muscle in patients under cancer treatment.

More data are required to define the imaging protocols and further analysis and correlation of the imaging with the clinical history of the disease and the histological findings.