Cardio-oncology: the Nuclear Option.
Cardio-oncology focuses increased effort to decrease cancer treatment-related cardiotoxicity while continuing to improve outcomes. We sought to synthesize the latest in nuclear cardiology as it pertains to the assessment of left ventricular function in preventative guidelines and comparison to other modalities, novel molecular markers of pre-clinical cardiotoxicity, and its role in cardiac amyloid diagnosis.



Planar ERNA (equilibrium radionuclide angiocardiography) provides a reliable and proven means of monitoring and preventing anthracycline cardiotoxicity, and SPECT ERNA using solid-state gamma cameras may provide reproducible assessments of left ventricular function with reduced radiation exposure. While certain chemotherapeutics have vascular side effects, the use of stress perfusion imaging has still not been adequately studied for routine use. Similarly, markers of apoptosis, inflammation, and sympathetic nerve dysfunction are promising, but are still not ready for uniform usage. SPECT tracers can assist in nonbiopsy diagnosis of cardiac amyloid. Nuclear cardiology is a significant contributor to the multimodality approach to cardio-oncology.
Warren Alpert Medical School, Brown University, Providence, RI, USA.
Jorge A
JA
Alvarez
Warren Alpert Medical School, Brown University, Providence, RI, USA. raymond.russell@lifespan.org.
Raymond R
RR
Russell
D018943:Anthracyclines / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D066126:Cardiotoxicity / Q000517:prevention & control; D015637:Gated Blood-Pool Imaging; D006321:Heart; D006333:Heart Failure / Q000139:chemically induced / Q000000981:diagnostic imaging; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000187:drug effects; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy*; D013318:Stroke Volume; D015899:Tomography, Emission-Computed, Single-Photon; D000068878:Trastuzumab / Q000009:adverse effects*; D016277:Ventricular Function, Left / Q000187:drug effects* / Q000528:radiation effects
D018943:Anthracyclines; D000970:Antineoplastic Agents; D000068878:Trastuzumab
Anthracycline; Cardio-oncology; Cardiotoxicity; Nuclear imaging; Trastuzumab