Cardio-oncology: the Nuclear Option

Area of Science:

• Cardio-oncology
• Nuclear Cardiology
• Cardiotoxicity Assessment

Background:

• Cardio-oncology aims to mitigate cancer treatment-related heart damage while improving patient outcomes.
• Accurate assessment of left ventricular function is crucial for managing cardiotoxicity.
• Multimodality approaches are essential in modern cardio-oncology practice.

Purpose of the Study:

• To review the latest advancements in nuclear cardiology for cardio-oncology.
• To evaluate nuclear cardiology's role in assessing left ventricular function and guiding preventative strategies.
• To explore novel molecular markers for pre-clinical cardiotoxicity and nuclear cardiology's utility in cardiac amyloidosis diagnosis.

Main Methods:

• Review of planar and SPECT equilibrium radionuclide angiocardiography (ERNA) for left ventricular function assessment.
• Discussion of stress perfusion imaging limitations in chemotherapy-induced vascular side effects.
• Evaluation of emerging molecular markers (apoptosis, inflammation, sympathetic dysfunction) and SPECT tracers for cardiac amyloid diagnosis.

Main Results:

• Planar and SPECT ERNA are reliable for monitoring cardiotoxicity and assessing left ventricular function, with SPECT offering reduced radiation exposure.
• Novel molecular markers show promise but require further validation for routine clinical use.
• SPECT tracers facilitate non-biopsy diagnosis of cardiac amyloidosis.

Conclusions:

• Nuclear cardiology, particularly ERNA, is integral to cardio-oncology for monitoring cardiotoxicity and assessing cardiac function.
• While promising, molecular markers and stress perfusion imaging require further research for widespread adoption.
• Nuclear cardiology significantly contributes to the multimodality diagnosis and management of cardiac conditions in cancer patients.