Cardiac Magnetic Resonance Imaging and echocardiography in the detection of cardiotoxicity in cancer patients: A feasibility study

To perform MRI, echocardiograms and serum biomarkers at pre-treatment and post-treatment time points for detection of cardiac dysfunction. Each test is an addition to standard care. The study echocardiograms and cardiac MRI scans and serum biomarkers as outlined above will be performed at 1) baseline prior to commencement of any chemotherapy or radiotherapy, then at 2) 6-8 weeks post radiotherapy and then again at approximately 12 months after completion of the last active cancer treatment (either chemotherapy or radiotherapy). Patients from Cohorts A to C inclusive undergoing chemotherapy prior to radiotherapy, will have their study-related imaging performed at a 2-3 week interval post chemotherapy. Patients will thus undergo a minimum of 2 and a maximum of 4 echocardiograms and cardiac MRI scans (pre and post chemotherapy, and/or pre and post radiotherapy), depending on the patient’s cancer treatment program. For each MRI scan, the patient will lay still on a flat bed which moves through a cylindrical tunnel scanner. The scan will take approximately 20 minutes. For each echocardiogram, the patient will undergo an ultra-sound test laying on a bed, and can take approximately 20 minutes. At each study time-point, cardiac toxicity will be documented by the study clinicians by taking a directed cardiac history, examination, and scoring toxicity as per the Common Terminology Criteria for Adverse Events V4 grading system, and NYHA score. All appointments will be captured and noted on the patient's electronic medical record at their hospital. Serum biomarker testing involves bloods sample taken and analysed in a laboratory.