Advanced imaging modalities to detect cardiotoxicity

Awadalla, Magid; Hassan, M; Alvi, Raza M.; Neilan, Tomas G.

doi:10.1016/j.currproblcancer.2018.05.005

Cited by 24 publications

(17 citation statements)

References 75 publications

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“…Specifically, longitudinal evaluation of dose‐dependent RT‐induced damage requires registering MR data onto planning CTs from which quantitative dosimetry maps are formed. Notably, cardiac magnetic resonance (CMR) is an established technique to assess the function and structure of the heart (e.g., ventricular volumes, ejection fraction, left ventricular strains, LGE, and tissue characterization using T1/T2 mapping), 32,33 particularly for evaluating chemotherapy and radiotherapy‐induced CVT in long‐term thoracic cancer survivors (e.g., lung, breast, or lymphatic tissue) 33–36 . For example, prior studies have shown that CMR can detect significant T1 changes, declining ejection fraction, abnormalities in myocardial strain, and left atrial‐scar enhanced volume following RT 37–40 .…”

Section: Discussionmentioning

confidence: 99%

Quantitative assessment of intra‐ and inter‐modality deformable image registration of the heart, left ventricle, and thoracic aorta on longitudinal 4D‐CT and MR images

Omidi

Weiss

Wilson

et al. 2021

J Applied Clin Med Phys

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Purpose Magnetic resonance imaging (MRI)‐based investigations into radiotherapy (RT)‐induced cardiotoxicity require reliable registrations of magnetic resonance (MR) imaging to planning computed tomography (CT) for correlation to regional dose. In this study, the accuracy of intra‐ and inter‐modality deformable image registration (DIR) of longitudinal four‐dimensional CT (4D‐CT) and MR images were evaluated for heart, left ventricle (LV), and thoracic aorta (TA). Methods and materials Non‐cardiac‐gated 4D‐CT and T1 volumetric interpolated breath‐hold examination (T1‐VIBE) MRI datasets from five lung cancer patients were obtained at two breathing phases (inspiration/expiration) and two time points (before treatment and 5 weeks after initiating RT). Heart, LV, and TA were manually contoured. Each organ underwent three intramodal DIRs ((A) CT modality over time, (B) MR modality over time, and (C) MR contrast effect at the same time) and two intermodal DIRs ((D) CT/MR multimodality at same time and (E) CT/MR multimodality over time). Hausdorff distance (HD), mean distance to agreement (MDA), and Dice were evaluated and assessed for compliance with American Association of Physicists in Medicine (AAPM) Task Group (TG)‐132 recommendations. Results Mean values of HD, MDA, and Dice under all registration scenarios for each region of interest ranged between 8.7 and 16.8 mm, 1.0 and 2.6 mm, and 0.85 and 0.95, respectively, and were within the TG‐132 recommended range (MDA < 3 mm, Dice > 0.8). Intramodal DIR showed slightly better results compared to intermodal DIR. Heart and TA demonstrated higher registration accuracy compared to LV for all scenarios except for HD and Dice values in Group A. Significant differences for each metric and tissue of interest were noted between Groups B and D and between Groups B and E. MDA and Dice significantly differed between LV and heart in all registrations except for MDA in Group E. Conclusions DIR of the heart, LV, and TA between non‐cardiac‐gated longitudinal 4D‐CT and MRI across two modalities, breathing phases, and pre/post‐contrast is acceptably accurate per AAPM TG‐132 guidelines. This study paves the way for future evaluation of RT‐induced cardiotoxicity and its related factors using multimodality DIR.

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Section: Discussionmentioning

confidence: 99%

Quantitative assessment of intra‐ and inter‐modality deformable image registration of the heart, left ventricle, and thoracic aorta on longitudinal 4D‐CT and MR images

Omidi

Weiss

Wilson

et al. 2021

J Applied Clin Med Phys

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“…In order to illustrate the challenges of deploying imaging as a biomarker of safety, consider the risks of cardiotoxicity in cancer therapy. 175 This includes any structural or functional heart injury related to cancer treatment. Injury most commonly involves the myocardium leading to heart failure (HF) but can also include the pericardium, valves or coronary arteries.…”

Section: Timothy J Mccarthy Phd Pfizer Usamentioning

confidence: 99%

Emerging technologies and their impact on regulatory science

Anklam

Bahl

Ball

et al. 2021

Exp Biol Med (Maywood)

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There is an evolution and increasing need for the utilization of emerging cellular, molecular and in silico technologies and novel approaches for safety assessment of food, drugs, and personal care products. Convergence of these emerging technologies is also enabling rapid advances and approaches that may impact regulatory decisions and approvals. Although the development of emerging technologies may allow rapid advances in regulatory decision making, there is concern that these new technologies have not been thoroughly evaluated to determine if they are ready for regulatory application, singularly or in combinations. The magnitude of these combined technical advances may outpace the ability to assess fit for purpose and to allow routine application of these new methods for regulatory purposes. There is a need to develop strategies to evaluate the new technologies to determine which ones are ready for regulatory use. The opportunity to apply these potentially faster, more accurate, and cost-effective approaches remains an important goal to facilitate their incorporation into regulatory use. However, without a clear strategy to evaluate emerging technologies rapidly and appropriately, the value of these efforts may go unrecognized or may take longer. It is important for the regulatory science field to keep up with the research in these technically advanced areas and to understand the science behind these new approaches. The regulatory field must understand the critical quality attributes of these novel approaches and learn from each other's experience so that workforces can be trained to prepare for emerging global regulatory challenges. Moreover, it is essential that the regulatory community must work with the technology developers to harness collective capabilities towards developing a strategy for evaluation of these new and novel assessment tools.

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“…ECHO allows clinicians to assess the LV volume, dimensions, and overall function. Furthermore, the ECHO allows for visualization of any valvular or pericardial pathologies [ 74 ]. Due to the increased prevalence of cardiac complications with chemotherapy in the pediatric population, monitoring throughout the course of chemotherapy treatment is essential and can be useful in mitigating long-term cardiovascular toxicity.…”

Section: Reviewmentioning

confidence: 99%

Pediatric Chemotherapy Drugs Associated With Cardiotoxicity

Hitawala¹,

Jain²,

Castellanos³

et al. 2021

Cureus

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Pediatric cancers are a common cause of childhood morbidity. As a result, chemotherapeutic regimens have been designed to target childhood cancers. These medications are necessary to treat pediatric cancers, however, oncology management options are accompanied by multiple negative and potentially fatal adverse effects. Although anthracyclines are the most commonly used chemotherapeutic agents associated with cardiotoxicity, we also explore other chemotherapeutic drugs used in children that can potentially affect the heart. Genetic variations resulting in single nucleotide polymorphism (SNP) have the propensity to modify the cardiotoxic effects of the chemotherapy drugs. The clinical presentation of the cardiac effects can vary from arrhythmias and heart failure to completely asymptomatic. A range of imaging studies and laboratory investigations can protect the heart from severe outcomes. The physiology of the heart and the effect of drugs in children vary vividly from adults; therefore, it is crucial to study the cardiotoxic effect of chemotherapy drugs in the pediatric population. This review highlights the potential contributing factors for cardiotoxicity in the pediatric population and discusses the identification and management options.

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Advanced imaging modalities to detect cardiotoxicity

Cited by 24 publications

References 75 publications

Quantitative assessment of intra‐ and inter‐modality deformable image registration of the heart, left ventricle, and thoracic aorta on longitudinal 4D‐CT and MR images

Quantitative assessment of intra‐ and inter‐modality deformable image registration of the heart, left ventricle, and thoracic aorta on longitudinal 4D‐CT and MR images

Emerging technologies and their impact on regulatory science

Pediatric Chemotherapy Drugs Associated With Cardiotoxicity

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