Julia Kar1, Michael V Cohen2, Samuel A McQuiston3, Maria S Figarola3, Christopher M Malozzi2. 1. Departments of Mechanical Engineering and Pharmacology, University of South Alabama, 150 Jaguar Drive, Mobile, AL 36688, United States of America. Electronic address: jkar@southalabama.edu. 2. Department of Cardiology, College of Medicine, University of South Alabama, 1700 Center Street, Mobile, AL 36604, United States of America. 3. Department of Radiology, University of South Alabama, 2451 USA Medical Center Drive, Mobile, AL 36617, United States of America.
Abstract
PURPOSE: This study applied a novel and automated contractility analysis tool to investigate possible cardiotoxicity-related left-ventricular (LV) dysfunction in breast cancer patients following treatment with anti-neoplastic chemotherapy agents (CTA). Subclinical dysfunction otherwise undetected via LV ejection fraction (LVEF) was determined. METHODS: Deformation data were acquired with the Displacement Encoding with Stimulated Echoes (DENSE) MRI sequence on 16 female patients who had CTA-based treatment. The contractility analysis tool consisting of image quantization-based boundary detection and the meshfree Radial Point Interpolation Method was used to compare chamber quantifications, 3D regional strains and torsion between patients and healthy subjects (N = 26 females with N = 14 age-matched). Quantifications of patient LVEFs from DENSE and Steady-State Free Precession (SSFP) acquisitions were compared, Bland-Altman interobserver agreements measured on their strain results and differences in contractile parameters with healthy subjects determined via Student's t-tests. RESULTS: A significant difference was not found between DENSE and SSFP-based patient LVEFs at 58 ± 7% vs 57 ± 9%, p = 0.6. Bland-Altman agreements were - 0.01 ± 0.05 for longitudinal strain and 0.1 ± 1.3° for torsion. Differences in basal diameter indicating enlargement, 5.2 ± 0.5 cm vs 4.5 ± 0.5 cm, p < 0.01, and torsion, 4.7 ± 1.0° vs 8.1 ± 1.1°, p < 0.001 in the mid-ventricle and 5.9 ± 1.2° vs 10.2 ± 0.9°, p < 0.001 apically, were seen between patients and age-matched healthy subjects and similarly in longitudinal strain, but not in LVEF. CONCLUSIONS: Results from the statistical analysis reveal the likelihood of LV remodeling in this patient subpopulation otherwise not indicated by LVEF measurements. Published by Elsevier Inc.
PURPOSE: This study applied a novel and automated contractility analysis tool to investigate possible cardiotoxicity-related left-ventricular (LV) dysfunction in breast cancerpatients following treatment with anti-neoplastic chemotherapy agents (CTA). Subclinical dysfunction otherwise undetected via LV ejection fraction (LVEF) was determined. METHODS: Deformation data were acquired with the Displacement Encoding with Stimulated Echoes (DENSE) MRI sequence on 16 female patients who had CTA-based treatment. The contractility analysis tool consisting of image quantization-based boundary detection and the meshfree Radial Point Interpolation Method was used to compare chamber quantifications, 3D regional strains and torsion between patients and healthy subjects (N = 26 females with N = 14 age-matched). Quantifications of patient LVEFs from DENSE and Steady-State Free Precession (SSFP) acquisitions were compared, Bland-Altman interobserver agreements measured on their strain results and differences in contractile parameters with healthy subjects determined via Student's t-tests. RESULTS: A significant difference was not found between DENSE and SSFP-based patient LVEFs at 58 ± 7% vs 57 ± 9%, p = 0.6. Bland-Altman agreements were - 0.01 ± 0.05 for longitudinal strain and 0.1 ± 1.3° for torsion. Differences in basal diameter indicating enlargement, 5.2 ± 0.5 cm vs 4.5 ± 0.5 cm, p < 0.01, and torsion, 4.7 ± 1.0° vs 8.1 ± 1.1°, p < 0.001 in the mid-ventricle and 5.9 ± 1.2° vs 10.2 ± 0.9°, p < 0.001 apically, were seen between patients and age-matched healthy subjects and similarly in longitudinal strain, but not in LVEF. CONCLUSIONS: Results from the statistical analysis reveal the likelihood of LV remodeling in this patient subpopulation otherwise not indicated by LVEF measurements. Published by Elsevier Inc.
Entities:
Keywords:
3D strain; Breast Cancer; Cardiotoxicity; DENSE; LVEF; Left-ventricular contractility; RPIM