Galán-Arriola C, et al. – In this study, researchers used serial multiparametric cardiac magnetic resonance (CMR) to identify early doxorubicin-induced cardiotoxicity, and investigated its pathological correlates in a large animal model. Of 20 included pigs, 5 biweekly intracoronary doxorubicin doses (0.45 mg/kg/injection) were administered to 5 pigs. They were followed until sacrifice at 16 weeks. Three biweekly doxorubicin doses were administered to another 5 pigs, which were followed to 16 weeks. A third group was sacrificed after the third dose. Every week, CMR examinations including anatomical and T₂ and T₁ mapping (including extracellular volume [ECV] quantification) were performed in all groups. Following the initial CMR, a control group was sacrificed. The earliest marker of anthracycline-induced cardiotoxicity revealed by T₂ mapping during treatment was intracardiomyocyte edema generation, in the absence of T₁ mapping, ECV, or left ventricular (LV) motion defects. These changes occurred at a reversible disease stage, suggesting the clinical potential of this CMR marker for tailored anthracycline therapy.