TABLE 4.
Strengths and Limitations of Different Imaging Modalities for Diagnosis and Monitoring of Cardiotoxicitya
| IMAGING MODALITY | VOLUME/FUNCTION | TISSUE/MASS | MYOCARDITIS/INFLAMMATION | VALVE DISEASE | PERICARDIAL DISEASE | CORONARY DISEASE/ISCHEMIA | RADIATION EXPOSURE | REPRODUCIBILITY ACCURACY | COST | AVAILABILITY | BEDSIDE TEST OPTION | EXAMINATION TIME | VIRAL INFECTION RISK |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2D Echo | + | + | 0 | +++ | ++ | 0 | None | + | + | +++ | +++ | + to +++ | ++ |
| TEE | + | + | 0 | +++ | + | 0 | None | ++ | ++ | ++ | +++ | + to ++ | +++ |
| CMR | +++b | +++b | +++ | ++ | +++ | +++ | None | +++ | +++ | ++ | 0 | ++ | + |
| Nuclearc | + + | + | + | 0 | ++ | ++ | +++ | ++ | + | ++ | 0 | + | + |
| CCTA | + | + | 0 | + | ++ | +++d | +/++ | +++ | ++ | ++ | 0 | +++ | + |
Abbreviations: 2D Echo, 2-dimensional echocardiography; CCTA, coronary computed tomography angiogram; CMR, cardiac magnetic resonance; TEE, transesophageal echocardiography.
Modalities are scored as follows: +++, excellent diagnostic accuracy or features/high cost; ++, intermediate diagnostic accuracy or features/intermediate cost; +, reasonable diagnostic accuracy or features/low cost; 0, unable to diagnose.
This is the established gold standard.
Nuclear imaging modalities include single-photon emission computed tomography and multigated acquisition.
CCTA is the only noninvasive test that provides anatomic information with regard to the presence of coronary disease, and it also allows for imaging of the lung parenchyma, which shows characteristic changes in coronavirus disease 2019 and in the pulmonary vasculature and aorta (triple rule out); furthermore, it can identify pericardial effusion.
Modified from: Seraphim A, Westwood M, Bhuva AN, et al. Advanced imaging modalities to monitor for cardiotoxicity. Curr Treat Options Oncol. 2019; 20:73.51