Precision Cardio-Oncology and Nuclear Imaging: Current Applications, Molecular Innovations, and Future Trajectories.

Area of Science:

• Cardiology
• Oncology
• Nuclear Medicine

Background:

• Cancer therapies improve survival but cause long-term cardiovascular toxicity.
• Current cardiac surveillance detects damage after it occurs.
• Precision cardio-oncology needs earlier, mechanism-based detection methods.

Purpose of the Study:

• Evaluate nuclear imaging's role in precision cardio-oncology.
• Assess its ability for early, mechanism-based cardiotoxicity detection.
• Discuss innovations and future directions.

Main Methods:

• Narrative review of current literature.
• Summary of PET and SPECT imaging applications.
• Examination of molecular tracers and hybrid imaging.

Main Results:

• Nuclear imaging reveals myocardial perfusion, metabolism, inflammation, and microvascular dysfunction.
• Detects subclinical injury from anthracyclines, targeted agents, and immune checkpoint inhibitors.
• Integrates molecular imaging with conventional methods for personalized strategies.

Conclusions:

• Nuclear imaging is a valuable tool for early cardiotoxicity detection in precision cardio-oncology.
• It aids in risk stratification and personalized surveillance.
• Further integration is needed to optimize cardiovascular outcomes in cancer care.