Nuclear imaging in detection and monitoring of cardiotoxicity

Table 2 Techniques used for detection of anticancer therapy cardiomiopathy

Methods	Advantages	Limits
Echocardiography	Non-invasive Absence of adverse effects Analysis of systolic and diastolic function Tissue velocity imaging and strain imaging useful for early detection of subclinical alteration	Inter- and intra-observer variability Low sensitivity of EF assessment for early diagnosis
Magnetic resonance imaging	Accurate heart anatomic description Absence of radiation exposure Accurate and reproducible EF assessment Cardiac innervation assessment	Limited availability High costs Not applicable in patients with metallic device Low information about its role in the early detection
Multiple-gated acquisition scintigraphy	High sensitivity and specificity EF assessment No inter- and intra-observer variability	Low sensitivity of EF for early diagnosis Less information about diastolic function Radiation exposure
Positron emission tomography	Myocardial metabolic and perfusion evaluation	Limited availability

EF: Ejection fraction.