Cardiovascular Magnetic Resonance Imaging in Cardio-Oncology: An Expert Consensus Statement from the Society for Cardiovascular Magnetic Resonance. Endorsed by the International Cardio-Oncology Society (ICOS).
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This document represents a position statement from the Society for Cardiovascular Magnetic Resonance (SCMR) on recommendations for clinical utilization of cardiovascular magnetic resonance (CMR) in patients with cancer. The document was prepared by the SCMR Consensus Group on CMR Imaging for Cardio-Oncology and endorsed by the SCMR Publications Committee and SCMR Executive Committee. This document aims to: (1) guide the informed selection and timing of CMR; (2) inform clinical decision-making based on CMR findings; (3) educate stakeholders on the advantages and limitations of CMR in specific clinical scenarios; and (4) provide suggested protocols to tailor the CMR exam to the particular clinical question. The statements of clinical utility presented in the current document focus on the following clinical scenarios: evaluating left ventricular dysfunction with ejection fraction and volumes; identifying pre-clinical left ventricular (LV) dysfunction with myocardial strain; and myocardial injury or edema with parametric mapping and late gadolinium enhancement (LGE); myocarditis; vascular toxicity, with a focus on coronary artery disease (CAD); iron overload; cardiac amyloidosis; pericardial disease; valvular disease; pulmonary hypertension; and cardiac masses. Sections devoted to the special situations of radiation therapy (RT), hematopoietic stem cell transplantation (HSCT), and survivorship and pediatrics are also included. As an expert consensus statement, some recommendations are based on expert opinion and accepted best practices. This position statement emphasizes the optimal utilization of CMR in oncology patients with known or suspected cardiovascular disease; however, the authors acknowledge that CMR is not always locally available or accessible. Finally, the principal aim of this position statement is to provide specific recommendations on the use of CMR to help improve the health of cancer patients with cardiovascular disease.