Cardiac computed tomography in cardio-oncology: an update on recent clinical applications

Author:

Rosmini Stefania1,Aggarwal Ankita2,Chen Daniel H134,Conibear John5,Davies Ceri L1,Dey Amit Kumar67,Edwards Paula8,Guha Avirup9ORCID,Ghosh Arjun K134

Affiliation:

1. Cardiology Department, Barts Heart Centre, St Bartholomew’s Hospital, London EC1A 7BE, UK

2. Department of Internal Medicine, Wayne State University, Providence Hospital, Rochester, MI, USA

3. Cardio-Oncology Service, University College London Hospital, London, UK

4. Hatter Cardiovascular Institute, University College London, London, UK

5. Oncology Department, Barts Cancer Centre, St Bartholomew’s Hospital London, UK

6. National Heart, Lung and Blood Institute, Bethesda, USA

7. Department of Internal Medicine, Georgetown University, Washington, DC, USA

8. Rollins School of Public Health, Emory University, Atlanta, GA, USA

9. Harrington Heart and Vascular Institute, Cleveland, 11100 Euclid Ave, Cleveland, OH 44106, USA

Abstract

Abstract Chemotherapy and radiotherapy have drastically improved cancer survival, but they can result in significant short- and long-term cardiovascular complications, most commonly heart failure from chemotherapy, whilst radiotherapy increases the risk of premature coronary artery disease (CAD), valve, and pericardial diseases. Cardiac computed tomography (CT) with calcium scoring has a role in screening asymptomatic patients for premature CAD, cardiac CT angiography (CTCA) allows the identification of significant CAD, also in the acute settings where concerns exist towards invasive angiography. CTCA integrates the diagnostic work-up and guides surgical/percutaneous management of valvular heart diseases and allows the assessment of pericardial conditions, including detection of effusion and pericardial calcification. It is a widely available and fast imaging modality that allows a one-step evaluation of CAD, myocardial, valvular, and pericardial disease. This review aims to provide an update on its current use and accompanying evidence-base for cardiac CT in the management of cardio-oncology patients.

Funder

NIH

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine,Radiology, Nuclear Medicine and imaging,General Medicine

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