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Congress: ECR25
Poster Number: C-14348
Type: Poster: EPOS Radiologist (scientific)
Authorblock: L. Ye, K. Tao, Y. Xu, M-X. Yang, H. Luo, H-Y. Xu, Y-K. Guo; Chengdu/CN
Disclosures:
Lu Ye: Nothing to disclose
Kai Tao: Nothing to disclose
Yanjiani Xu: Nothing to disclose
Meng-Xi Yang: Nothing to disclose
Hong Luo: Nothing to disclose
Hua-Yan Xu: Nothing to disclose
Ying-Kun Guo: Nothing to disclose
Keywords: Cardiac, MR, Chemotherapy, Treatment effects, Cancer, Toxicity
Methods and materials

Study design

This study is part of a registered clinical research (registration No. ChiCTR-DDD-17013450,http://www.chictr.org.cn). It was approved by the institutional research ethics board of the authors’ hospital, and written informed consent was obtained from each participation prior to the investigation. In this single-center prospective cohort study, we screened patients with gynecologic cancer undergoing chemotherapy in the Division of Chemotherapy and Radiotherapy in the Department of Gynecology from September 2018 to August 2022. This study also recruited age-matched female healthy volunteers as healthy control subjects. Patients with LVEF ≥ 55% were classified as preserved LVEF (PLVEF) group, and patients with LVEF < 55% were classified as reduced LVEF (RLVEF) group.  

Cardiac MRI

Patients and normal controls were examined in the supine position using a 3.0 T scanner. All images were obtained during breath-holding in end-expiration, and electrocardiographic gating was employed. To quantify the cardiac structure and function, 8 to 12 continuous sections were obtained from the mitral valve level to LV apex in the short-axis view using a balanced steady-state free precession pulse sequence. The vertical two-chamber long axis and horizontal four-chamber cine series were scanned using the same sequences used with the short-axis images.

Imaging analysis

Cine MRI data were analyzed by professional post-processing software to detect LVEF and LV deformation (Fig.1).

Fig 1: Measurement of MR tissue tracking. Tracing the endo- (red curve) and epicardial (green curve) borders on the short axis (A), 4-chamber (B), and 2-chamber long axis (C) cine images; define the short axis reference point (blue and red points) at the insertion of the right ventricle and left ventricle on the short axis slice.
 A set of short-axis, four-chamber and long-axis two-chamber slices were loaded into the tissue tracking module. Tissue tracking deformation parameters included LV radial, circumferential, longitudinal strain and strain rate (SR). Strain parameters included global strain and regional strain at basal, middle and apical levels.

Examination of serum myocardial injury biomarkers

Serum myocardial injury biomarkers which include cardiac troponin I (cTnI), myohemoglobin (Myo), creatine kinase (CK) and cardiac isoenzyme of creatine kinase (CK-MB) were measured on the day of CMR examination.

Statistical analysis

For the comparison of continuous variables between the patient group and the normal control group, an independent t-test or rank-sum test was employed as appropriate.For the comparison of continuous variables among the PLVEF group, RLVEF group, and normal controls, an ordinary one-way ANOVA or Kruskal–Wallis test was employed as appropriate. Among patients who completed CMR follow-up, parameters between the two scans were compared using a paired t-test or Wilcoxon signed-rank test as appropriate. For correlation analysis between two variables, Pearson’s or Spearman’s correlation analysis was applied as appropriate. Subsequently, variables were included in a multivariate linear regression model to identify factors independently associated with the deformation parameters. A p-value of <0.05 was considered statistically significant.
GALLERY