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Insight into Noninvasive Radiological Modalities to Detect Heart Transplant Rejection
Dhruva Sharma1, Ganapathy Subramaniam2, Neha Sharma3
1Department of Cardiothoracic and Vascular Surgery, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan, India.
The Indian Journal of Radiology & Imaging
|February 9, 2022
Summary
Noninvasive imaging shows promise for detecting heart transplant rejection (HTR). Speckle tracking echocardiography and cardiac MRI can screen patients, potentially reducing the need for invasive biopsies.
Area of Science:
- Cardiology
- Radiology
- Transplant Medicine
Background:
- Heart transplantation is crucial for end-stage heart failure.
- Noninvasive tests for heart transplant rejection (HTR) are under development.
- Endomyocardial biopsy (EMB) remains the gold standard despite limitations.
Purpose of the Study:
- To review noninvasive radiological modalities for detecting HTR.
- To assess the clinical robustness of current noninvasive imaging techniques.
- To highlight the need for improved diagnostic tools in heart transplant recipients.
Main Methods:
- Comprehensive literature search of PubMed, Embase, and Google Scholar.
- Keywords included "Heart transplantation," "Acute allograft rejection," "Echocardiography," and "Cardiac magnetic resonance imaging."
- Data compiled from inception until September 2020.
Main Results:
- Deformation imaging (speckle tracking) and T2 time (cardiac MRI) show potential as screening tools.
- These noninvasive methods can guide further invasive investigations.
- Standardization of these modalities could offer clinical and financial benefits.
Conclusions:
- Diagnosing HTR noninvasively remains challenging.
- Prospective multicentric studies are needed to validate noninvasive modalities.
- Noninvasive techniques could become the standard of care, complementing EMB.
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