Expert Consensus for Multi-Modality Imaging Evaluation of Cardiovascular Complications of Radiotherapy in Adults: A Report from the European Association of Cardiovascular Imaging and the American Society of Echocardiography

• DOI: 10.1016/j.echo.2013.07.005
• Publication Date: 2013-08-31T00:28:49Z
• Authors: Patrizio Lancellotti; Vuyisile T. Nkomo; Luigi P. Badano; Jutta Bergler; Jan Bogaert; Laurent Davin; Bernard Cosyns; Philippe Coucke; Raluca Dulgheru; Thor Edvardsen; Oliver Gaemperli; Maurizio Galderisi; Brian Griffin; Paul A. Heidenreich; Koen Nieman; Juan C. Plana; Steven C. Port; Marielle Scherrer...; Ronald G. Schwartz; Igal A. Sebag; Jens-Uwe Voigt; Samuel Wann; Phillip C. Yang
• Keywords: Cardiac computed tomography; Cardiac magnetic resonance; Echocardiography; Heart disease; Nuclear cardiology; Radiotherapy; Adult; Dose-Response Relationship, Radiation; Echocardiography; Heart; Humans; Middle Aged; Multimodal Imaging; Neoplasms; Radiation Injuries; Radiotherapy, Adjuvant; Risk; Radiology, Nuclear Medicine and Imaging; Cardiology and Cardiovascular Medicine; Adult; Risk; Cardiac computed tomography; Consensus; Cardiac magnetic resonance; 610 Medicine & health; heart disease; Heart disease; nuclear cardiology; Multimodal Imaging; 2705 Cardiology and Cardiovascular Medicine; cardiac magnetic resonance; Dose-Response Relationship; 03 medical and health sciences; 0302 clinical medicine; SDG 3 - Good Health and Well-being; Nuclear Medicine and Imaging; Neoplasms; 2741 Radiology, Nuclear Medicine and Imaging; echocardiography; Humans; cardiac computed tomography; Radiation Injuries; Adjuvant; radiotherapy; EMC NIHES-03-30-01; Radiation; Radiotherapy; cardiac computed tomography; cardiac magnetic resonance; echocardiography; heart disease; nuclear cardiology; radiotherapy; Adult; Cardiovascular Diseases; Consensus; Dose-Response Relationship, Radiation; Europe; Heart; Humans; Multimodal Imaging; Neoplasms; Radiation Injuries; Radiotherapy; Risk; United States; Nuclear cardiology; Dose-Response Relationship, Radiation; Heart; Middle Aged; United States; 3. Good health; Europe; Echocardiography; Cardiovascular Diseases; 10209 Clinic for Cardiology; Radiotherapy, Adjuvant; Radiology; Cardiology and Cardiovascular Medicine; EMC COEUR-09

Cardiac toxicity is one of the most concerning side effects of anti-cancer therapy. The gain in life expectancy obtained with anti-cancer therapy can be compromised by increased morbidity and mortality associated with its cardiac complications. While radiosensitivity of the heart was initially recognized only in the early 1970s, the heart is regarded in the current era as one of the most critical dose-limiting organs in radiotherapy. Several clinical studies have identified adverse clinical consequences of radiation-induced heart disease (RIHD) on the outcome of long-term cancer survivors. A comprehensive review of potential cardiac complications related to radiotherapy is warranted. An evidence-based review of several imaging approaches used to detect, evaluate, and monitor RIHD is discussed. Recommendations for the early identification and monitoring of cardiovascular complications of radiotherapy by cardiac imaging are also proposed.