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Cardiovascular Magnetic Resonance in the Oncology Patient.

ABSTRACT: Patients with or receiving potentially cardiotoxic treatment for cancer are susceptible to developing decrements in left ventricular mass, diastolic function, or systolic function. They may also experience valvular heart disease, pericardial disease, or intracardiac masses. Cardiovascular magnetic resonance may be used to assess cardiac anatomy, structure, and function and to characterize myocardial tissue. This combination of features facilitates the diagnosis and management of disease processes in patients with or those who have survived cancer. This report outlines and describes prior research involving cardiovascular magnetic resonance for assessing cardiovascular disease in patients with or previously having received treatment for cancer.

SUBMITTER: Jordan JH

PROVIDER: S-EPMC6242266 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

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Cardiovascular Magnetic Resonance in the Oncology Patient.

Jordan Jennifer H JH Todd Ryan M RM Vasu Sujethra S Hundley W Gregory WG

JACC. Cardiovascular imaging 20180801 8

Patients with or receiving potentially cardiotoxic treatment for cancer are susceptible to developing decrements in left ventricular mass, diastolic function, or systolic function. They may also experience valvular heart disease, pericardial disease, or intracardiac masses. Cardiovascular magnetic resonance may be used to assess cardiac anatomy, structure, and function and to characterize myocardial tissue. This combination of features facilitates the diagnosis and management of disease processe ...[more]

PMID: 30092971

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Project description:BackgroundTo determine the effect of hydration as well as prone versus supine positioning on the pelvic veins during cardiovascular magnetic resonance (CMR) venography.MethodsUnder institutional review board approval, 8 healthy subjects were imaged with balanced steady state free precession, non-contrast CMR venography to measure common and external iliac vein volumes and common femoral vein cross-sectional area in the supine, prone and decubitus positions after dehydration and again following re-hydration. CMR venography from 23 patients imaged both supine and prone were retrospectively reviewed and measurements of common femoral and iliac veins areas were compared using Wilcoxon test.ResultsCommon femoral vein area on CMR venography increased with prone positioning (83?±?35 mm2) compared to supine positioning (59?±?21 mm2) (p?=?0.02) and further increased with hydration to 123?±?44 mm2 (p?<?0.01). With right and left side down decubitus positioning, the common femoral vein area on dehydration increased from 29?±?17 mm2 in the ante-dependent position to 134?±?36 mm2 in the dependent position (p?<?0. 001). Similarly, common and external iliac veins increased in volume with prone, 5.4?±?1.9 cm3 and 5.8?±?1.9 cm3 compared to supine positioning 4.6?±?1.8 cm3 and 4.5?±?1.9 cm3 (p?=?0.01) and further increase with hydration to 6.7?±?2.1 cm3 and 6.3?±?1.9 cm3 (p?=?0.01). CMR venography on patients also demonstrated an increase in mean common femoral vein luminal area from 103?±?44 mm2 in supine position to 151?±?52 mm2 with prone positioning (p?<?0.001) as well as increases in common and external iliac vein volumes from 6.5?±?2.6 cm3 and 8.0?±?3.4 cm3 in the supine position to 7.5?±?2.5 cm3 and 9.3?±?3.6 cm3 with prone positioning (p?<?0.01).ConclusionsCommon femoral and common/external iliac vein size on CMR venography may be affected by position and hydration status. Routine clinical CMR venography of the pelvis could include prone positioning and avoiding dehydration to maximize pelvic vein distension.

Project description:The aim of this study is to determine the test-retest reliability of the measurement of regional myocardial function by cardiovascular magnetic resonance (CMR) tagging using spatial modulation of magnetization.Twenty-five participants underwent CMR tagging twice over 12?±?7 days. To assess the role of slice orientation on strain measurement, two healthy volunteers had a first exam, followed by image acquisition repeated with slices rotated ±15 degrees out of true short axis, followed by a second exam in the true short axis plane. To assess the role of slice location, two healthy volunteers had whole heart tagging. The harmonic phase (HARP) method was used to analyze the tagged images. Peak midwall circumferential strain (Ecc), radial strain (Err), Lambda 1, Lambda 2, and Angle ? were determined in basal, mid and apical slices. LV torsion, systolic and early diastolic circumferential strain and torsion rates were also determined.LV Ecc and torsion had excellent intra-, interobserver, and inter-study intra-class correlation coefficients (ICC range, 0.7 to 0.9). Err, Lambda 1, Lambda 2 and angle had excellent intra- and interobserver ICC than inter-study ICC. Angle had least inter-study reproducibility. Torsion rates had superior intra-, interobserver, and inter-study reproducibility to strain rates. The measurements of LV Ecc were comparable in all three slices with different short axis orientations (standard deviation of mean Ecc was 0.09, 0.18 and 0.16 at basal, mid and apical slices, respectively). The mean difference in LV Ecc between slices was more pronounced in most of the basal slices compared to the rest of the heart.Intraobserver and interobserver reproducibility of all strain and torsion parameters was excellent. Inter-study reproducibility of CMR tagging by SPAMM varied between different parameters as described in the results above and was superior for Ecc and LV torsion. The variation in LV Ecc measurement due to altered slice orientation is negligible compared to the variation due to slice location.This trial is registered as NCT00005487 at National Heart, Lung and Blood institute.

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Cardiovascular Magnetic Resonance in the Oncology Patient.

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Cardiovascular Magnetic Resonance in the Oncology Patient.

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