1. UAB medical Center, Birmingham VA Medical Center
Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology
Comprehensive Review on Cardio-Oncology: Role of Multi-Modality Imaging
Carol Chen-Scarabelli, Chad McRee, Massoud Leesar, Fadi Hage, Tiziano Scarabelli
UAB medical Center, Birmingham VA Medical Center
Copyright American Society of Nuclear Cardiology

2. Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology
BACKGROUND
Cancer and cardiovascular (CV) disease are the two leading causes of mortality worldwide. Evolving oncologic therapy, including the use of newer targeted agents, has led to an improvement in survival from childhood and adult-onset cancers. Consequently, there has been a growing realization of cardiotoxic complications related to cancer therapy, with some complications manifesting months to decades after completion of cancer treatment. This manuscript reviews cancer therapeutics-related cardiovascular toxicity and its manifestations, multi-modality imaging techniques for surveillance and detection of this complication, and current state of knowledge in this emerging field.
Keywords: cancer, cardiotoxicity, chemotherapy, imaging, radiation
Copyright American Society of Nuclear Cardiology

3. METHODS Study type: (Select all that apply)
Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology
METHODS
Study type: (Select all that apply)
review
Study subjects: cancer patients treated with chemotherapy and/or radiation therapy
Study endpoints:
Primary end point(s): cardiotoxicity
Secondary end point(s): imaging for detection of cardiotoxicity
Study variables: cardiotoxicity, radiation-induced heart disease, imaging
Copyright American Society of Nuclear Cardiology

4. Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology
RESULTS A B
Peak systolic Global Longitudinal Strain (GLS) measured by speckle-tracking echocardiography (STE) along with left ventricular ejection fraction (LVEF) calculation by 3 dimensional echocardiography (3DE) (panel A) and Multi-Gated Acquisition (MUGA) scan (panel B) used for surveillance of left ventricular ejection fraction in cancer patients undergoing chemotherapy.
Copyright American Society of Nuclear Cardiology

5. Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology
CONCLUSIONS
Numerous diagnostic modalities exist for evaluation of detrimental myocardial changes, such as echocardiography, MUGA, CT, MRI, PET-CT, PET-MRI. While serial clinical assessment is warranted in conjunction with cardiac imaging, it must be reiterated that there is currently a paucity of data with no randomized-controlled trials regarding approaches to detect cardiotoxicity. There exists a need for evolving methods in screening and monitoring, as well as standardized outcome measures, for cardiac dysfunction related to oncologic treatment.
Copyright American Society of Nuclear Cardiology