Published online Jul 28, 2014. doi: 10.4329/wjr.v6.i7.486
Revised: April 21, 2014
Accepted: May 29, 2014
Published online: July 28, 2014
Cardiotoxicity as a result of cancer treatment is a novel and serious public health issue that has a significant impact on a cancer patient’s management and outcome. The coexistence of cancer and cardiac disease in the same patient is more common because of aging population and improvements in the efficacy of antitumor agents. Left ventricular dysfunction is the most typical manifestation and can lead to heart failure. Left ventricular ejection fraction measurement by echocardiography and multigated radionuclide angiography is the most common diagnostic approach to detect cardiac damage, but it identifies a late manifestation of myocardial injury. Early non-invasive imaging techniques are needed for the diagnosis and monitoring of cardiotoxic effects. Although echocardiography and cardiac magnetic resonance are the most commonly used imaging techniques for cardiotoxicity assessment, greater attention is focused on new nuclear cardiologic techniques, which can identify high-risk patients in the early stage and visualize the pathophysiologic process at the tissue level before clinical manifestation. The aim of this review is to summarize the role of nuclear imaging techniques in the non-invasive detection of myocardial damage related to antineoplastic therapy at the reversible stage, focusing on the current role and future perspectives of nuclear imaging techniques and molecular radiotracers in detection and monitoring of cardiotoxicity.
Core tip: Cardiomyopathy is a potential complication of various anticancer drugs, such as anthracyclines and biological therapy. Left ventricular dysfunction is the most common manifestation of cardiotoxicity and is monitored with left ventricular ejection fraction measurement, but it is a late manifestation of myocardial injury. Thus, the cardiologist and oncologist should collaborate to identify new non-invasive techniques to detect cardiac dysfunction at an early and potentially reversible stage, before the onset of clinical manifestation. To achieve this aim, nuclear imaging techniques may offer good future perspectives for early detection of myocardial damage using novel molecular tracers.