Table 1.

Strengths and limitations of multimodality imaging techniques in diabetic cardiomyopathy.

Modality	Strength	Limitation
Echocardiography	• High temporal and spatial resolutions, accessibility, affordability, harmlessness • Effective in detecting early diastolic dysfunction • Critical for early detection and monitoring of DMCM	• Operator-dependent diagnostic accuracy • Compromised image quality in patients with poor acoustic windows • Limited information on myocardial tissue characterization and metabolism
Cardiac MRI	• Higher spatial and temporal resolution, assesses myocardial fibrosis and altered metabolism • Can identify myocardial scar tissue and abnormal diastolic function • Comprehensive tissue characterization, high-resolution imaging	• Perceived expense burden, patient comfort issues, longer examination times • Risk of nephrogenic systemic fibrosis with older generation Gadolinium-based contrast media
Nuclear Imaging	• Detects low-density processes, measures myocardial metabolism, assesses molecular imaging • Flexible radiotracer design, accurate radiotracer localization with combined techniques • Reveals significant metabolic alterations in DMCM	• High cost and limited availability • Low spatial resolution compared to CMR, concerns about radiation exposure • Requires specialized expertise for interpretation