Evidence map›Paper›PMID 41168847›Full record

ReviewCardio-oncology (London, England)2025

A call to action: improving access to cardiac MRI for diagnosis of immune checkpoint inhibitor related myocarditis in low and middle income countries.

Aruni Ghose, Abhinav Kandala, Isha Sabnis, Maryam Hasanova, Carl Simela, Charlotte Manisty, Suvro Banerjee, Sebastian Szmit, Mark Westwood, Ariane V S Macedo and 11 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Cardio-oncology (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Aruni Ghose *Cardio-Oncology Service, Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK.
Abhinav Kandala *University College London Medical School, London, UK.
Isha SabnisSchool of Medicine and Population Health, University of Sheffield, Sheffield, UK.
Maryam HasanovaDivision of Biosciences, University College London, London, UK.
Carl SimelaCardio-Oncology Service, University College London Hospitals NHS Foundation Trust, London, UK.
Charlotte ManistyCardio-Oncology Service, Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK.
Suvro BanerjeeInternational Cardio-Oncology Society, Tampa, FL, USA.
Sebastian SzmitInternational Cardio-Oncology Society, Tampa, FL, USA.
Mark WestwoodCardio-Oncology Service, Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK.
Ariane V S MacedoInternational Cardio-Oncology Society, Tampa, FL, USA.
Daniel Sierra-Lara MartinezInternational Cardio-Oncology Society, Tampa, FL, USA.
Andrès J DanieleInternational Cardio-Oncology Society, Tampa, FL, USA.
Vanita NoronhaDepartment of Medical Oncology, Tata Memorial Hospital, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, India.
Trishun SinghInternational Cardio-Oncology Society, Tampa, FL, USA.
Bonnie KyThalheimer Center for Cardio-Oncology, Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.
Sola AdelekeSchool of Biomedical Engineering & Imaging Sciences, King's College London, London, UK.
Akash ManiamCaribbean Cancer Research Institute, El Socorro, Trinidad and Tobago.
Stephen J CasselliInternational Cardio-Oncology Society, Tampa, FL, USA.
Daniel J LenihanInternational Cardio-Oncology Society, Tampa, FL, USA.
Susan Dent *International Cardio-Oncology Society, Tampa, FL, USA.
Arjun Kumar Ghosh *Cardio-Oncology Service, Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK. arjun.ghosh@nhs.net.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Immune checkpoint inhibitor (ICI) therapy is a rapidly expanding pillar of cancer treatment, but it carries the risk of immune-related adverse events. Among the most fatal is ICI-related myocarditis (ICIRM). Cardiac magnetic resonance (CMR) imaging is the non-invasive current gold standard for diagnosis, with significant disparities regarding availability and utilisation. The vast majority of ICIRM cases are reported in high-income countries (HICs), reflecting not only patterns of ICI use, but also a profound diagnostic gap in low- and middle-income countries (LMICs). LMICs face barriers to CMR access, including a stark deficit of MRI scanners, with approximately 1 scanner per million people in LMICs versus 26 per million people in HICs, prohibitive costs, and a critical shortage of trained radiologists and cardiologists. The inequity means that as ICI therapy becomes increasingly accessible worldwide, patients in resource-limited settings will be at a high-risk of undiagnosed and untreated ICIRM. Our paper issues a call to address this critical healthcare disparity. To improve CMR access for ICIRM diagnosis in LMICs, a multi-pronged strategy is imperative - Governmental support and policy change to prioritise infrastructure investment and integrate CMR into national health strategies; targeted educational programmes, such as the SWiM and 'train the trainer' initiatives, to build local expertise in CMR acquisition and interpretation; adoption of technological innovations, including cost-effective rapid CMR protocols and artificial intelligence (AI) tools that can reduce scan times.

Identifiers

PMID41168847
PMCPMC12574015

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.