Novel imaging paradigms for characterization of cardiovascular toxicities associated with cancer therapy

Since the 1970s, there have been many paradigm shifts in the detection of cardiotoxicity associated with cancer treatment. These have included movement away from late sequelae of cancer treatment such as heart failure or decline in ejection fraction toward earlier detection of subclinical toxicity using echocardiographically derived global longitudinal strain and high sensitivity troponin assays. In addition to this, cardiac MRI has had an expanding role in detecting cardiotoxicity due to its reproducibility in left ventricular ejection fraction measurements and tissue characterization. This article summarizes the strengths and weaknesses of these imaging techniques in characterizing cardiotoxicity in patients receiving cancer therapy.