Fig. 2

Cardiac magnetic resonance imaging in a 59-year-old woman with human epidermal growth factor receptor 2 positive left-side breast cancer. Left ventricular ejection fraction was 66% at baseline and 56% at follow-up. Top images (a–e) are at baseline. Bottom images (f–j) are after four cycles of the taxanes plus carboplatin plus trastuzumab plus pertuzumab regimen (95 days after the baseline scan). Axial T2-weighted images (a, f) show a decrease in the tumour size of the left breast (arrows). Short-axis cine images (b, g) demonstrate an increase in left ventricular end-systolic internal diameter (2.3 cm at baseline, 48 cm at follow-up). T2 mapping images (c, h) show a slight increase in T2 relaxation time in the septum of the mid short-axis slice (44 ms at baseline, 48 ms at follow-up). T1 mapping images (d, i) show a slight increase in T1 relaxation time in the septum of the mid short-axis slice (1,154 ms at baseline, 1,195 ms at follow-up). Global radial, circumferential and longitudinal strains before and after four cycles of therapy (e, j). GCS Global circumferential strain, GLS Global longitudinal strain, GRS Global radial strain