Department of Radiology, The Affiliated Hospital of Southwest Medical University, 25# Tai Ping Street, Luzhou, 646000, Sichuan, China.
Department of Clinical Science, Philips Healthcare, Chengdu, 610000, China.
Eur Radiol. 2024 Jan;34(1):226-235. doi: 10.1007/s00330-023-10027-1. Epub 2023 Aug 8.
To evaluate the early prevalence of anthracycline-induced cardiotoxicity (AIC) and anthracycline-induced liver injury (AILI) using T2 and T2* mapping and to explore their correlations.
The study included 17 cardiotoxic rabbits that received weekly injections of doxorubicin and magnetic resonance imaging (MRI) every 2 weeks for 10 weeks. Cardiac function and T2 and T2* values were measured on each period. Histopathological examinations for two to five rabbits were performed after each MRI scan. The earliest sensitive time and the threshold of MRI parameters for detecting AIC and AILI based on these MRI parameters were obtained. Moreover, the relationship between myocardial and liver damage was assessed.
Early AIC could be detected by T2 mapping as early as the second week and focused on the 7th, 11th, and 12th segments of left ventricle. The cutoff value of 46.64 for the 7th segment had the best diagnostic value, with an area under the curve (of 0.767, sensitivity of 100%, and specificity of 52%. T2* mapping could detect the change in iron content for early AIC at the middle interventricular septum and AILI as early as the sixth week (p = 0.014, p = 0.027). The T2* values of the middle interventricular septum showed a significant positive association with the T2* values of the liver (r = 0.39, p = 0.002).
T2 and T2* mapping showed value one-stop assessment of AIC and AILI and could obtain the earliest MRI diagnosis point and optimal parameter thresholds for these conditions.
Anthracycline-induced cardiotoxicity could be detected by T2 mapping as earlier as the second week, mainly focusing on the 7th, 11th, and 12th segments of left ventricle. Combined with T2* mapping, hepatoxicity and supplementary cardiotoxicity were assessed by one-stop scan.
• MRI screening time of cardiotoxicity was as early as the second week with focusing on T2 values of the 7th, 11th, and 12th segments of left ventricle. • T2* mapping could be used as a complement to T2 mapping to evaluate cardiotoxicity and as an effective index to detect iron change in the early stages of chemotherapy. • The T2* values of the middle interventricular septum showed a significant positive association with the T2* values of the liver, indicating that iron content in the liver and heart increased with an increase in the chemotherapeutic drugs.
使用 T2 和 T2* 映射评估蒽环类药物诱导的心脏毒性（AIC）和蒽环类药物诱导的肝损伤（AILI）的早期患病率，并探讨它们之间的相关性。
本研究纳入了 17 只接受多柔比星每周注射的心脏毒性兔，并在 10 周内每 2 周进行一次 MRI 检查。在每个时间段测量心脏功能和 T2 和 T2* 值。在每次 MRI 扫描后对两到五只兔子进行组织病理学检查。基于这些 MRI 参数，获得了最早的敏感时间和用于检测 AIC 和 AILI 的 MRI 参数的阈值。此外，评估了心肌和肝脏损伤之间的关系。
T2 映射最早可在第二周检测到早期 AIC，主要集中在左心室的第 7、11 和 12 节段。第 7 节段的截断值为 46.64 时具有最佳的诊断价值，曲线下面积（AUC）为 0.767，灵敏度为 100%，特异性为 52%。T2* 映射最早可在第六周检测到中隔心肌铁含量的变化和 AILI（p=0.014，p=0.027）。中隔心肌的 T2* 值与肝脏的 T2* 值呈显著正相关（r=0.39，p=0.002）。
T2 和 T2* 映射对 AIC 和 AILI 具有一站式评估价值，可获得这些疾病的最早 MRI 诊断点和最佳参数阈值。
T2 映射最早可在第二周检测到蒽环类药物引起的心脏毒性，主要集中在左心室的第 7、11 和 12 节段。结合 T2* 映射，可通过一次扫描来评估肝毒性和补充性心脏毒性。
