Cardiotoxicity in Cancer Therapy

The Role of Cardiovascular Magnetic Resonance Imaging
2019-07-11

Christian P. Houbois1,2; Paaladinesh Thavendiranathan, MD SM1,3,4; Bernd J. Wintersperger, MD EBCR FAHA1,2
1Department of Medical Imaging, Peter Munk Cardiac Centre, University Health Network, Toronto, Canada
2Department of Medical Imaging, University of Toronto, Toronto, Canada
3Division of Cardiology, Peter Munk Cardiac Centre, University Health Network, Toronto, Canada
4Department of Medicine, University of Toronto, Toronto, Canada

The breadth of techniques available in CMR for assessment of cardiac function, myocardial deformation and myocardial tissue characterization makes it a potentially ideal tool for assessment and monitoring of patients with increased risk of developing cancer therapy related
cardiotoxicity.

Cardiovascular magnetic resonance (CMR) imaging has become a mainstay in the assessment of various cardiac pathologies including ischemic and non-ischemic cardiomyopathies. Beyond the sole aspect of functional deterioration, CMR has convincingly demonstrated to provide further information on the underlying cause contributing sufficient information to narrow the differential diagnosis. Furthermore, insight into the myocardial composition may shed light into the risk prediction of certain diseases and may also allow monitoring of therapeutic interventions and their effects on the heart.

In recent years, the link between tumor therapies and cardiac disease has gained substantial attention. With the continuous improvement of survival rates of patients with various malignancies, potential detrimental effects on cardiac function and outcome including increased morbidity and mortality has become the center of such investigations. Major centers with large oncology and cardiac programs have started to establish Cardio-Oncology clinics, in order to help guide oncologists in their treatment planning in patients with pre-existing cardiac disease as well as taking care of patients with potential tumor therapy regimen related cardiovascular effects and potential development of heart failure.


Bernd J. Wintersperger, MD EBCR FAHA

Bernd J. Wintersperger, MD EBCR FAHA is Professor of Radiology and Associate Vice Chair Research (Heart-Lung-Vessel) at the University of Toronto. He is also Director MRI and Director Cardiac Imaging Operations at Department of Medical Imaging Toronto General Hospital, Toronto, Ontario, Canada. Dr. Wintersperger’s research focuses mainly on cardiovascular CT and MR imaging but also on therapy response biomarkers in antio-angiogenic tumor therapy and contrast agents. Dr. Wintersperger is on the reviewer panel of various radiology and cardiology journals, is a member of the Editorial Board for European Radiology and Investigative Radiology and is the responsible Associate Editor for all Cardiac Radiology Submissions of Investigative Radiology.