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Chronic Anthracycline-related Myocarditis Presenting as Diffuse Myocardial Calcification
Marijan Pejic1, Monica Shifman2, Trevor Rose3
1Department of Radiology, University of South Florida, Tampa, Florida, USA.
Journal of Clinical Imaging Science
|December 11, 2019
Summary
Cardiovascular magnetic resonance (CMR) is crucial for diagnosing myocarditis in cardio-oncology, especially with cancer therapies causing cardiotoxicity. Newer CMR techniques improve diagnostic accuracy for detecting this condition.
Area of Science:
- Cardio-oncology
- Cardiovascular Magnetic Resonance (CMR)
- Myocarditis
Background:
- Cardio-oncology is increasingly focused on diagnosing myocarditis, often caused by cancer therapies like anthracyclines and immune checkpoint inhibitors.
- Cardiotoxicity from cancer treatment is a recognized cause of myocarditis, necessitating prompt management adjustments.
Observation:
- Conventional CMR for myocarditis involves assessing left ventricular structure/function and gadolinium enhancement.
- Advanced CMR sequences, including native T1 mapping and extracellular volume fraction, enhance diagnostic capabilities.
- A case presented involved subacute/chronic myocarditis from anthracycline therapy, suspected due to incidental myocardial calcifications on CT.
Findings:
- Newer CMR sequences offer improved diagnostic accuracy over conventional methods for myocarditis.
- Myocardial calcifications on CT can be an incidental finding prompting further investigation for cardiotoxicity.
Implications:
- Early and accurate diagnosis of cancer therapy-induced myocarditis is vital for patient management.
- Integrating advanced CMR techniques can improve the detection and characterization of myocarditis.
- Multimodality imaging, including CT and CMR, plays a role in identifying cardiotoxicity.
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