PDF(Pubmed)
Abstract：
BACKGROUND: This review focuses on multimodality imaging of cardiotoxicity in cancer patients, with the aim of evaluating the effectiveness of different techniques in detecting and monitoring cardiac changes associated with cancer therapy.
METHODS: Eight studies were included in the review, covering various imaging modalities such as cardiac magnetic resonance imaging, echocardiography, and multigated acquisition scanning.
RESULTS: Cardiac magnetic resonance imaging emerged as the most definitive modality, offering real-time detection, comprehensive assessment of cardiac function, the ability to detect early myocardial changes, and superior detection of cardiotoxicity when compared to the other imaging modalities. The studies also emphasize the importance of parameters such as left ventricular ejection fraction and global longitudinal strain in assessing cardiac function and predicting cardiotoxicity.
CONCLUSIONS: Due to the common use of HER2 agents and anthracyclines within the breast cancer population, the LVEF as a critical prognostic measurement for assessing heart health and estimating the severity of left-sided cardiac malfunction is a commonly used endpoint. CTRCD rates differed between imaging modalities, with cardiac MRI the most sensitive. The use of multimodal cardiac imaging remains a nuanced area, influenced by local availability, the clinical question at hand, body habits, and medical comorbidities. All of the imaging modalities listed have a role to play in current care; however, focus should be given to increasing the provision of cardiac MRI for breast cancer patients in the future to optimize the detection of CTRCD and patient outcomes thereafter.
METHODS: Eight studies were included in the review, covering various imaging modalities such as cardiac magnetic resonance imaging, echocardiography, and multigated acquisition scanning.
RESULTS: Cardiac magnetic resonance imaging emerged as the most definitive modality, offering real-time detection, comprehensive assessment of cardiac function, the ability to detect early myocardial changes, and superior detection of cardiotoxicity when compared to the other imaging modalities. The studies also emphasize the importance of parameters such as left ventricular ejection fraction and global longitudinal strain in assessing cardiac function and predicting cardiotoxicity.
CONCLUSIONS: Due to the common use of HER2 agents and anthracyclines within the breast cancer population, the LVEF as a critical prognostic measurement for assessing heart health and estimating the severity of left-sided cardiac malfunction is a commonly used endpoint. CTRCD rates differed between imaging modalities, with cardiac MRI the most sensitive. The use of multimodal cardiac imaging remains a nuanced area, influenced by local availability, the clinical question at hand, body habits, and medical comorbidities. All of the imaging modalities listed have a role to play in current care; however, focus should be given to increasing the provision of cardiac MRI for breast cancer patients in the future to optimize the detection of CTRCD and patient outcomes thereafter.
摘要：
背景：这篇综述集中于癌症患者心脏毒性的多模态成像，目的是评估不同技术在检测和监测与癌症治疗相关的心脏变化方面的有效性。
方法：本综述包括8项研究，涵盖各种成像模式，如心脏磁共振成像，超声心动图,和多路采集扫描。
结果：心脏磁共振成像成为最确定的模式，提供实时检测，心脏功能的综合评估，检测早期心肌变化的能力，与其他成像方式相比，心脏毒性检测更好。研究还强调了左心室射血分数和整体纵向应变等参数在评估心脏功能和预测心脏毒性方面的重要性。
结论：由于在乳腺癌人群中普遍使用HER2药物和蒽环类药物，LVEF作为评估心脏健康和估计左侧心功能不全严重程度的关键预后指标是常用的终点.CTRCD率在成像模式之间存在差异，心脏MRI最敏感.多模式心脏成像的使用仍然是一个微妙的领域，受当地可用性的影响，手头的临床问题，身体习惯,和医疗合并症。列出的所有成像方式都在当前的护理中发挥作用；然而，未来应将重点放在增加为乳腺癌患者提供心脏MRI,以优化CTRCD的检测和此后的患者结局.
方法：本综述包括8项研究，涵盖各种成像模式，如心脏磁共振成像，超声心动图,和多路采集扫描。
结果：心脏磁共振成像成为最确定的模式，提供实时检测，心脏功能的综合评估，检测早期心肌变化的能力，与其他成像方式相比，心脏毒性检测更好。研究还强调了左心室射血分数和整体纵向应变等参数在评估心脏功能和预测心脏毒性方面的重要性。
结论：由于在乳腺癌人群中普遍使用HER2药物和蒽环类药物，LVEF作为评估心脏健康和估计左侧心功能不全严重程度的关键预后指标是常用的终点.CTRCD率在成像模式之间存在差异，心脏MRI最敏感.多模式心脏成像的使用仍然是一个微妙的领域，受当地可用性的影响，手头的临床问题，身体习惯,和医疗合并症。列出的所有成像方式都在当前的护理中发挥作用；然而，未来应将重点放在增加为乳腺癌患者提供心脏MRI,以优化CTRCD的检测和此后的患者结局.
