Table 1.

Imaging Modalities and Derived Phenotypes for Baseline Risk Assessment of Patients With Cancer

	TTE	CMR	Cardiac CT
Recommended parameters	•LVEDV and LVEF (ideally 3D TTE) •LAV, E/A measurement •RV diameter •GLS •RV FWLS and LA strain if available •S′ for mitral and tricuspid •TAPSE •Peak TRV •E/E′ •IVC diameter •Valvular and pericardial diseases	•LVEDV and RVEDV •LV mass •LVEF and RVEF •Longitudinal and circumferential strain if available •Myocardial characterization •T2w (STIR), T1, T2 maps, LGE	•Agatston score for cardiac CT and CAC-DRS for all noncontrast CT scans •LVEDV and LVEF •Coronary anatomy description
Clinical scenarios in which these imaging tests are recommended at baselinea	•All patients with pre-existing cardiovascular diseases •All patients receiving anthracyclines, HER2 therapies, proteasome inhibitors, CAR-T therapy, and HSCT •Patients at high cardiovascular toxicity risk receiving immunotherapy-targeted therapies (VEGF, bcr-abl TKIs, BRAF-MEKi, BTKi)	•Poor-quality TTE imaging or borderline results •Patients with pre-existing cardiovascular disease •New left ventricular impairment or cardiac symptoms on baseline TTE •Multiple myeloma where cardiac amyloidosis is suspected	•Symptomatic patients before any potentially cardiotoxic therapy •High-risk patients or those with known CAD before fluoropyrimidines, targeted therapies (VEGFi, second- and third-generation bcr-abl TKIs), IMIDs

3D = 3-dimensional; BRAF = rapidly accelerated fibrosarcoma B type; BTKi = Bruton tyrosine kinase inhibitor; CAC-DRS = coronary artery calcium data and reporting system; CAR-T = chimeric antigen receptor T cell; CMR = cardiac magnetic resonance; CT = computed tomography; E = mitral inflow early diastolic velocity obtained by pulsed wave; E′ = early diastolic velocity of the mitral annulus obtained by tissue Doppler imaging; FWLS = free wall longitudinal strain; GLS = global longitudinal strain; HER2 = human epidermal growth factor receptor 2; HSCT = hematopoietic stem cell transplantation; IMID = immunomodulatory agent; IVC = inferior vena cava; LA = left atrial; LAV = left atrial volume; LGE = late gadolinium enhancement; LV = left ventricular; LVEDV = left ventricular end-diastolic volume; LVEF = left ventricular ejection fraction; MEKi = mitogen-activated protein/extracellular signal-regulated/kinase inhibitor; RV = right ventricular; RVEDV = right ventricular end-diastolic volume; RVEF = right ventricular ejection fraction; S′ = systolic velocity of tricuspid annulus obtained by Doppler tissue imaging; STIR = short tau inversion recovery; TAPSE = tricuspid annular plane systolic excursion; TKI = tyrosine kinase inhibitors; TTE = transthoracic echocardiography; TRV = tricuspid regurgitation velocity; VEGF = vascular endothelial growth factor; VEGFi = vascular endothelial growth factor inhibitor.

^aEuropean Society of Cardiology guidelines included only class 1 indications for TTE.