Cardiac Magnetic Resonance Imaging in Immune Check-Point Inhibitor Myocarditis: A Systematic Review

被引:15
作者
Arcari, Luca [1 ]
Tini, Giacomo [2 ]
Camastra, Giovanni [1 ]
Ciolina, Federica [3 ]
De Santis, Domenico [4 ]
Russo, Domitilla [2 ]
Caruso, Damiano [4 ]
Danti, Massimiliano [3 ]
Cacciotti, Luca [1 ]
机构
[1] Madre Giuseppina Vannini Hosp, Cardiol Unit, I-00177 Rome, Italy
[2] Sapienza Univ Rome, Fac Med & Psychol, Cardiol Clin & Mol Med Dept, I-00100 Rome, Italy
[3] Madre Giuseppina Vannini Hosp, Radiol Unit, I-00177 Rome, Italy
[4] Sapienza Univ Rome, St Andrea Univ Hosp, Dept Med Surg Sci & Translat Med, Radiol Unit, I-00100 Rome, Italy
关键词
immune check-point inhibitor; myocarditis; cardiac magnetic resonance imaging; edema; fibrosis; T1; mapping; T2; CLINICAL-FEATURES; NATIVE T1; MANAGEMENT; EDEMA; INFLAMMATION; BLOCKADE; FIBROSIS; DISEASE; RISK; MR;
D O I
10.3390/jimaging8040099
中图分类号
TB8 [摄影技术];
学科分类号
0804 ;
摘要
Immune checkpoint inhibitors (ICIs) are a family of anticancer drugs in which the immune response elicited against the tumor may involve other organs, including the heart. Cardiac magnetic resonance (CMR) imaging is increasingly used in the diagnostic work-up of myocardial inflammation; recently, several studies investigated the use of CMR in patients with ICI-myocarditis (ICI-M). The aim of the present systematic review is to summarize the available evidence on CMR findings in ICI-M. We searched electronic databases for relevant publications; after screening, six studies were selected, including 166 patients from five cohorts, and further 86 patients from a sub-analysis that were targeted for a tissue mapping assessment. CMR revealed mostly preserved left ventricular ejection fraction; edema prevalence ranged from 9% to 60%; late gadolinium enhancement (LGE) prevalence ranged from 23% to 83%. T1 and T2 mapping assessment were performed in 108 and 104 patients, respectively. When available, the comparison of CMR with endomyocardial biopsy revealed partial agreement between techniques and was higher for native T1 mapping amongst imaging biomarkers. The prognostic assessment was inconsistently assessed; CMR variables independently associated with the outcome included decreasing LVEF and increasing native T1. In conclusion, CMR findings in ICI-M include myocardial dysfunction, edema and fibrosis, though less evident than in more classic forms of myocarditis; native T1 mapping retained the higher concordance with EMB and significant prognostic value.
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页数:10
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