Cardiac computed tomography (CT) and magnetic resonance imaging (CMR) have shown potential in providing new insights concerning different cardiovascular pathologies. More recently, the focus of such studies has shifted from a simple qualitative evaluation of imaging, to a more objective approach, which includes the assessment of quantitative biomarkers. In particular, late gadolinium enhancement (LGE), myocardial strain and extracellular volume fraction (ECV) could be used to aim for a more tailored approach to the study of different diseases. The main applications for LGE discussed in this study include the definition of a more appropriate gadolinium-based contrast dosage for the assessment of myocardial infarction at CMR, and the appraisal of LGE patterns and roles in patients with Tetralogy of Fallot (ToF), the most common cyanogen congenital heart defect. The analysis of myocardial strain focused on the detection of subclinical contractility anomalies in patients with ToF, and with myocarditis, aiming for a quantitative approach which could help highlight early cardiac disease before myocardial function is irreversibly altered. The study of ECV, conversely, focused on the early detection of subclinical cardiotoxicity stemming from anthracycline treatment for breast cancer. Overall, the use of such quantitative biomarkers in imaging studies could help pave the way for a more tailored patient treatment, and towards personalized medicine.

CT- AND MRI-DERIVED BIOMARKERS FOR CARDIOVASCULAR DISEASE

MONTI, CATERINA BEATRICE
2021

Abstract

Cardiac computed tomography (CT) and magnetic resonance imaging (CMR) have shown potential in providing new insights concerning different cardiovascular pathologies. More recently, the focus of such studies has shifted from a simple qualitative evaluation of imaging, to a more objective approach, which includes the assessment of quantitative biomarkers. In particular, late gadolinium enhancement (LGE), myocardial strain and extracellular volume fraction (ECV) could be used to aim for a more tailored approach to the study of different diseases. The main applications for LGE discussed in this study include the definition of a more appropriate gadolinium-based contrast dosage for the assessment of myocardial infarction at CMR, and the appraisal of LGE patterns and roles in patients with Tetralogy of Fallot (ToF), the most common cyanogen congenital heart defect. The analysis of myocardial strain focused on the detection of subclinical contractility anomalies in patients with ToF, and with myocarditis, aiming for a quantitative approach which could help highlight early cardiac disease before myocardial function is irreversibly altered. The study of ECV, conversely, focused on the early detection of subclinical cardiotoxicity stemming from anthracycline treatment for breast cancer. Overall, the use of such quantitative biomarkers in imaging studies could help pave the way for a more tailored patient treatment, and towards personalized medicine.
23-feb-2021
Inglese
SARDANELLI, FRANCESCO
Università degli Studi di Milano
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.14242/75000
Il codice NBN di questa tesi è URN:NBN:IT:UNIMI-75000