Machine Learning Model Using Pre-Cancer Therapy Cardiac Magnetic Resonance Images to Predict Cancer Therapy-Related Cardiac Dysfunction

doi:10.1016/j.jcmg.2026.04.007

Cardio-oncology & other

Machine Learning Model Using Pre-Cancer Therapy Cardiac Magnetic Resonance Images to Predict Cancer Therapy-Related Cardiac Dysfunction

JACC Cardiovasc ImagingPublished 28 May 2026Diagnostic accuracy study

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Authors' conclusion

A DL model using pre-cancer therapy CMR short-axis cines can predict future CTRCD risk better than clinical or manually quantified imaging models.

Study context

Population: Women with HER2+ breast cancer receiving anthracyclines and trastuzumab (Toronto and Calgary, Canada)176 internal, 53 external
Participants: 229 women

Comparison: Pre-cancer therapy cardiac magnetic resonance (CMR) deep learning model vs HFA-ICOS risk score, CMR and echocardiographic models
Outcome: Prediction of cancer therapy-related cardiac dysfunction (CTRCD) (defined by CMR)

Methodological detailspooled from 3 prospective studies, internal and external validation

Pooled from 3 prospective studies
Internal and external validation

Performance

As reported in the abstract

Prediction of CTRCD

Test or model	AUC	F1 score
Deep learning (DL) model	0.85 (95% CI: 0.69-0.97)	0.69 (95% CI: 0.47-0.86)
HFA-ICOS	0.66 (95% CI: 0.53-0.75)	0.56 (95% CI: 0.47-0.61)
CMR	0.59 (95% CI: 0.41-0.73)	0.20 (95% CI: 0.00-0.42)
Echocardiography	0.62 (95% CI: 0.44-0.78)	0.36 (95% CI: 0.12-0.62)

AUC

Deep learning (DL) model0.85 (95% CI: 0.69-0.97)

HFA-ICOS0.66 (95% CI: 0.53-0.75)

CMR0.59 (95% CI: 0.41-0.73)

Echocardiography0.62 (95% CI: 0.44-0.78)

F1 score

Deep learning (DL) model0.69 (95% CI: 0.47-0.86)

HFA-ICOS0.56 (95% CI: 0.47-0.61)

CMR0.20 (95% CI: 0.00-0.42)

Echocardiography0.36 (95% CI: 0.12-0.62)

Further findings

Outcome	DL model
Prediction of CTRCD, external validation (Calgary)
AUC	0.80 (95% CI: 0.66-0.92)
F1 score	0.55 (95% CI: 0.24-0.77)

Original publication

Machine Learning Model Using Pre-Cancer Therapy Cardiac Magnetic Resonance Images to Predict Cancer Therapy-Related Cardiac Dysfunction. JACC Cardiovasc Imaging. Published 28 May 2026. doi:10.1016/j.jcmg.2026.04.007

Read the original article ↗PubMed

Summarised from the published abstract; every number is checked against it