Imaging modalities to detect and track cancer treatment-related cardiovascular dysfunction

Advances in cancer treatments have led to an increase in the number of cancer survivors, but also high rates of short- and long-term cardiovascular (CV) toxicities. The number of new cancer drugs is constantly increasing, and the increasing incidence of toxicities of these drugs make long-term care and monitoring difficult. Moreover, traditional type I and type II cardiotoxicities may not be applicable to all of these agents. Multidisciplinary care with expertise in oncology, cardiology and other related specialties is required to mitigate cancer therapeutics-related cardiovascular dysfunction (CTRCD). Accordingly, CTRCD should include all kinds of toxic/side effects affecting the CV system, including hypertension, endothelial and vascular dysfunction, accelerated atherosclerosis, thrombosis and bleeding, pulmonary hypertension, pericardial disease, QT prolongation, conduction disease/arrhythmias, as well as radiation-induced CV disease (CVD). This study reviews the currently recommended imaging modalities including advanced echocardiographic parameters including global longitudinal strain (GLS), left atrial strain (LAS), fast strain encoded cardiac magnetic resonance (CMR) imaging (fast-SENC) and T1 and T2 mapping, myocardial 18F-fluorodeoxyglucose (FDG) uptake in heart positron emission tomography (PET) and computed tomography coronary angiography for risk assessment, detection and early diagnosis of CTRCD. Experts in cardiology, oncology, hematology, and radio-oncology must work together closely to foster patient awareness and further research in this field.