Multi-Modality Imaging in the Assessment of Cardiovascular Toxicity in the Cancer Patient

Juan Carlos Plana*, Paaladinesh Thavendiranathan, Chiara Bucciarelli-Ducci, Patrizio Lancellotti

*Corresponding author for this work

Research output: Contribution to journalReview article (Academic Journal)peer-review

48 Citations (Scopus)
157 Downloads (Pure)


Cancer therapy can be associated with both cardiac and vascular toxicity. Advanced multi-modality imaging can be used to stratify patient risk, identify cardiovascular injury during and after therapy, and forecast recovery. Echocardiography continues to be the mainstay in the evaluation of cardiac toxicity. Particularly, echocardiography-based strain imaging is useful for risk stratification of patients at baseline, and detection of subclinical left ventricle (LV) dysfunction during therapy. Cardiac magnetic resonance (CMR) serves a complementary role in the patient with poor echocardiographic or equilibrium radionuclide angiographic image quality or in situations where a more accurate and precise LV ejection fraction measurement is needed to inform decisions regarding discontinuation of chemotherapy. New CMR techniques like T1 and T2 mapping and positron emission tomography (PET) imaging will help us better understand the structural, pathological, and metabolic myocardial changes associated with ventricular dysfunction or release of serum biomarkers. CMR may also be helpful in the evaluation of vascular complications of cancer therapy. Stress echocardiography, stress CMR, computed tomography, and PET are excellent imaging options in the evaluation of ischemia in patients receiving therapies that could potentially cause vasospasm or accelerated atherosclerosis.
Original languageEnglish
Pages (from-to)1173-1186
Number of pages14
JournalJACC: Cardiovascular Imaging
Issue number8
Early online date6 Aug 2018
Publication statusPublished - Aug 2018


  • cardio-oncology
  • cardiotoxicity
  • imaging


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  • NIHR BRC Cardiovascular

    Angelini, G. D.


    Project: Research, Parent

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