Multimodality imaging for cardiotoxicity: state of the art and future perspectives

Abstract

Modern cancer therapies have significantly improved survival leading to a growing population of cancer survivors. Similarly, both conventional and newer treatments are associated with a spectrum of cardiovascular disorders with potential long-term sequelae. Prompt detection and treatment of these complications is, therefore, pivotal to enable healthy survivorship and reduce cardiovascular morbidity. Advanced multimodality imaging is a valuable tool for stratifying patient risk, identifying cardiovascular toxicity during and after therapy, and predicting recovery. This review summarizes the potential cardiotoxic complications of anticancer therapies and the multimodality approaches available in each case with special focus on newer techniques and the added value of biomarkers ultimately leading to earlier diagnosis and better prognostication.

The intersection of heart failure and cancer in women: a review

“…However, MUGA is not the preferred imaging modality of choice in most cases due to ionizing radiation exposure, which is of significant concern in patients with breast cancer. Other limitations include the inability to obtain other cardiac functional and structural information, which can be obtained through echocardiography ( 107 ). Physiological or pharmacological stress myocardial perfusion imaging can be used to diagnose ischaemic heart disease as a cause of HF.…”

“…When echocardiographic image quality is inadequate for functional and volumetric assessment, CMR can be used as the first line modality of choice ( 111 ). Furthermore, in cases where echocardiography findings are abnormal such as a change in LVEF, CMR could be performed to confirm these findings prior to making decisions about management ( 107 ). CMR is also useful in tissue characterisation and the evaluation of ischaemic vs. non ischaemic pathologies ( 107 ).…”

“…Furthermore, in cases where echocardiography findings are abnormal such as a change in LVEF, CMR could be performed to confirm these findings prior to making decisions about management ( 107 ). CMR is also useful in tissue characterisation and the evaluation of ischaemic vs. non ischaemic pathologies ( 107 ).…”

Cardiovascular complications of anti-cancer therapy: a developing storm in medicine

“…Bannister et al 11 reviewed cardiotoxicities caused by chemotherapeutic agents and their treatment, focusing on the left ventricular systolic dysfunction, the most commonly encountered cancer therapy-mediated cardiotoxicity. Artico et al 12 summarized the available information on the detection of cancer therapy-induced or aggravated cardiac structural abnormalities by multiple imaging technologies. Timely detection of such abnormalities is critical for the management of the patients.…”