Imaging of early modification in cardiomyopathy: the doxorubicin-induced model

Int J Cardiovasc Imaging. 2013 Oct;29(7):1459-76. doi: 10.1007/s10554-013-0248-0. Epub 2013 Jun 7.

Abstract

Doxorubicin chemotherapy is effective and widely used to treat acute lymphoblastic leukemia. However, its effectiveness is hampered by a wide spectrum of dose-dependent cardiotoxicity including both morphological and functional changes, affecting primarily the myocardium. Non-invasive imaging techniques are used for the diagnosis and monitoring of these cardiotoxic effects. The purpose of this review is to summarize and compare the most common imaging techniques used in early detection and therapeutic monitoring of doxorubicin-induced cardiotoxicity and the suggested mechanisms of such side effects. Imaging techniques using echocardiography including conventional 2D and 3D echocardiography along with MRI sequences including Tagging, Cine, and quantitative MRI in detecting early myocardial damage are also reviewed. As there is a multitude of reported indices and imaging methods to assess particular functional alterations, we limit this review to the most relevant techniques based on their clinical application and their potential to early detection of doxorubicin-induced cardiotoxic effects.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Antibiotics, Antineoplastic / adverse effects*
  • Cardiomyopathies / chemically induced
  • Cardiomyopathies / diagnosis*
  • Diagnostic Imaging* / methods
  • Disease Models, Animal
  • Disease Progression
  • Dose-Response Relationship, Drug
  • Doxorubicin / adverse effects*
  • Drug Monitoring
  • Early Diagnosis
  • Echocardiography, Doppler, Color
  • Echocardiography, Three-Dimensional
  • Humans
  • Magnetic Resonance Imaging, Cine
  • Predictive Value of Tests
  • Time Factors

Substances

  • Antibiotics, Antineoplastic
  • Doxorubicin