ABSTRACT
Advances in cardiovascular imaging have allowed for more precise methods of quantifying cardiac function in a variety of disease states. With rising numbers of cancer survivors, there is increasing interest in using different imaging modalities for detection of cardiovascular toxicity in the cardio-oncologic patient population. Advanced imaging techniques, such as speckle tracking, 3-dimensional imaging, and use of contrast in echocardiography have the potential to predict subclinical cardiotoxicity in cancer patients receiving high-risk cancer treatments and allow for earlier cardioprotective interventions. Other advanced imaging modalities, such as cardiac magnetic resonance (CMR) and computed tomography (CT), provide high resolution visuals of myocardial function, valvular function, pericardial thickening, and coronary/peripheral artery disease. Nuclear imaging enables detection of coronary artery perfusion abnormalities, while vascular ultrasound can provide visualization of peripheral arterial/venous atherosclerotic and thrombotic complications of cancer and its treatment. We discuss the accuracy, advantages, and disadvantages of these various imaging techniques, as well as their applicability in detecting cardiovascular toxicity. We also review the current expert consensus statements from various societies regarding the frequency and duration of cardiotoxicity surveillance. Lastly, we consider the future avenues of investigation in determining the role of advanced multimodality cardiac imaging in this unique patient population.
