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A NON-INVASIVE BIOMECHANICAL MODEL-BASED ELASTICITY IMAGING METHOD FOR ASSESSING CHANGES IN MYOCARDIAL STIFFNESS TO PREDICT CARDIAC DEGRADATION IN BREAST CANCER PATIENTS

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abstract
Cardiac degradation as a result of breast cancer therapeutics is an emerging concern as breast cancer diagnoses are trending younger, and survival gains are continuing to be made. Evidence shows an emphasis on cardiac health during breast cancer therapy could have more of an impact on overall survival than focus on completing a full therapy cycle. Common breast cancer therapeutics are linked to cardiovascular events including anthracycline therapy, breast irradiation, and more recently hormone deprivation therapy. Pre-menopausal intermediate-high risk HR-positive breast cancer patients undergo severe estrogen depletion to improve cancer outcomes. Estrogen depletion for non-cancer reasons has been correlated with cardiovascular injury. In breast cancer patients with years of life to protect it is important to evaluate cardiac degradation to balance cardiovascular health with therapeutic outcome. Previous methods for assessing cardiac degradation are either too coarse for identifying preclinical disease, or too expensive and complicated to translate to the clinic. We developed a non-invasive biomechanical model-based methodology that solves for left ventricle (LV) mechanical elasticity in the longitudinal and radial directions using routinely acquired cardiac MR images. We examined myocardial elasticity imaging in premenopausal women either diagnosed with HR-positive breast cancer undergoing severe estrogen depletion or triple negative breast cancer (TNBC) patients after therapy completion. We show significant differences in LV elasticity in the longitudinal and radial directions, and in shear modulus in the HR-positive cohort compared to the TNBC comparator cohort, where traditional methods for identifying cardiac dysfunction were inconclusive. This study shows potential for our method of assessing mechanical stiffness change in the LV to indicate subclinical cardiac degradation in a breast cancer population undergoing therapy.
subject
biomechanical modeling
breast cancer
cardiotoxicity
elasticity
magnetic resonance imaging
contributor
Miller, Caroline Elizabeth (author)
Weis, Jared A (committee chair)
Jordan, Jennifer H (committee member)
Thomas, Alexandra (committee member)
Zhao, Dawen (committee member)
date
2021-09-01T08:35:31Z (accessioned)
2021 (issued)
degree
Biomedical Engineering (discipline)
2022-08-31 (liftdate)
embargo
2022-08-31 (terms)
identifier
http://hdl.handle.net/10339/99069 (uri)
language
en (iso)
publisher
Wake Forest University
title
A NON-INVASIVE BIOMECHANICAL MODEL-BASED ELASTICITY IMAGING METHOD FOR ASSESSING CHANGES IN MYOCARDIAL STIFFNESS TO PREDICT CARDIAC DEGRADATION IN BREAST CANCER PATIENTS
type
Thesis

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