Table 2.

Recommended Modality Without Specific Guidelines^a

Therapeutic Agent	Imaging Modality	Source
Immune checkpoint inhibitors	Echo
	Consider echo with strain imaging when suspicion of ICI toxicity exists: Definite myocarditis: New wall motion abnormality on echo not explained by another diagnosis (ie, acute coronary syndrome, stress‐induced cardiomyopathy, sepsis) and all of the following: (1) clinical syndrome consistent with myocarditis, (2) elevated biomarker of cardiac myonecrosis, (3) ECG evidence of myopericarditis, (4) negative angiography or other testing to exclude obstructive coronary disease Probable myocarditis: New wall motion abnormality on echo with a clinical syndrome consistent with myocarditis not otherwise explained by another diagnosis and either: (1) elevated biomarker of cardiac myonecrosis or (2) ECG evidence of myopericarditis Possible myocarditis: New wall motion abnormality on echo one of the following: (1) clinical syndrome consistent with myocarditis not explained by alternate diagnosis, (2) ECG evidence of myopericarditis	Bonaca et al101 Adawalla et al102 Waheed et al103
	CMR
	Consider CMR when suspicion for ICI‐induced myocarditis exists: Definite myocarditis: CMR diagnostic of myocarditis, a clinical syndrome not explained by alternate diagnosis, and one of following: (1) elevated biomarker of cardiac myonecrosis or (2) ECG evidence of myopericarditis Probable myocarditis: CMR with findings diagnostic of myocarditis not explained by alternate clinical diagnosis with any of the following: (1) clinical syndrome consistent with myocarditis, (2) elevated biomarker of cardiac myonecrosis, or (3) ECG evidence of myopericarditis Possible myocarditis: Nonspecific CMR findings suggestive of myocarditis with one or more of the following: (1) clinical syndrome consistent with myocarditis not explained by alternate clinical diagnosis, (2) elevated biomarker of cardiac myonecrosis, (3) ECG evidence of myopericarditis	Mahmood et al100 Bonaca et al101 Salem et al104
	18 FDG‐PET
	Scenario meeting criteria for possible myocarditis (see above) with PET showing patchy cardiac FDG uptake without another explanation	Bonaca et al101
Tyrosine kinase inhibitors	Echo
	In context of appropriate symptoms, screening echo test of choice to evaluate pulmonary pressures, right ventricular dysfunction or hypertrophy, septal deviation to the left to provide supporting evidence of pulmonary hypertension (Dasatinib useb)	Moslehi et al105
	CMR
	Consider CMR during evaluation of suspected TKI‐related ischemia (sorafenibb)	Sudasena et al92
	18 FDG‐PET
	Consider cardiac PET during evaluation of suspected TKI‐related ischemia (sorafenibb)	Sudasena et al92 Toubert et al91
Proteasome inhibitors	Echo
	Consider echo with strain imaging when evaluating LV systolic and diastolic parameters for suspected proteasome inhibitor LV dysfunction	Gavazzoni et al50 Iannaccone et al51
Radiation therapy	CMR
	Consider T1‐weighted mapping in the evaluation in suspected radiation induced myocardial fibrosis	Mukai‐Yatagai et al59

18‐FDG PET indicates 18‐fluorodeoxyglucose positron emission tomography; CMR, cardiac magnetic resonance imaging; GLS, global longitudinal strain; ICI, immune checkpoint inhibitor; LVEF, left ventricular ejection fraction; TKI, tyrosine kinase inhibitor.

^aReflects emerging data that may show efficacy to additional applications of cardiac CT, MRI, and PET in broader applications.

^bRecommendations apply only to specific agent, not class.