Skip to main content

Advertisement

SpringerLink
Log in

The Role of Imaging with Cardiac Computed Tomography in Cardio-Oncology Patients

  • Cardio-Oncology (SA Francis, Section Editor)
  • Published:
Current Cardiology Reports Aims and scope Submit manuscript

Abstract

Cardiovascular diseases and cancer represent the two most common causes of morbidity and mortality in industrialized countries. With the increase in long-term survival of cancer patients, cardiovascular diseases are the leading cause of mortality for many cancer survivors. In this article, we will review the most common cardiovascular toxicities of cancer therapies and will describe the role of cardiac CT in the detection and monitoring of cardiovascular disease. While there is limited evidence for the use of CT imaging in cancer patients, we will discuss the utility of cardiac CT in the detection and management of coronary artery disease, pericardial and valvular heart disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Ahn SG, Lee HM, Lee SA. Long-term survival analysis of Korean breast cancer patients at a single center: improving outcome over time. Yonsei Med J. 2014;55:1187–95.

    Article  PubMed  PubMed Central  Google Scholar 

  2. DeSantis CE, Lin CC, Mariotto AB, et al. Cancer treatment and survivorship statistics, 2014. CA Cancer J Clin. 2014;64:252–71.

    Article  PubMed  Google Scholar 

  3. Groarke JD, Nguyen PL, Nohria A. Cardiovascular complications of radiation therapy for thoracic malignancies: the role for non-invasive imaging for detection of cardiovascular disease. Eur Heart J. 2014;35:612–23.

    Article  PubMed  Google Scholar 

  4. Mertens AC, Liu Q, Neglia JP, et al. Cause-specific late mortality among 5-year survivors of childhood cancer: the Childhood Cancer Survivor Study. J Natl Cancer Inst. 2008;100:1368–79.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Bradshaw PT, Stevens J, Khankari N. Cardiovascular disease mortality among breast cancer survivors. Epidemiology. 2016;27:6–13.

    Article  PubMed  Google Scholar 

  6. Armstrong GT, Chen Y, Yasui Y, et al. Reduction in late mortality among 5-year survivors of childhood cancer. N Engl J Med. 2016;374:833–42.

    Article  CAS  PubMed  Google Scholar 

  7. Yusuf SW, Sami S, Daher IN. Radiation-induced heart disease: a clinical update. Cardiol Res Pract. 2011;2011:317659.

    PubMed  PubMed Central  Google Scholar 

  8. Armenian SH, Xu L, Ky B, et al. Cardiovascular disease among survivors of adult-onset cancer: a community-based retrospective cohort study. J Clin Oncol. 2016;34:1122–30. This retrospective cohort study included patients with most common cancer types such as breast and lung cancer, non-Hodgkin’s lymphoma and multiple myeloma. Cancer patients had an increased prevalence of cardiovascular disease and higher burden of traditional risk factors. Overall survival in cancer patients who developed cardiovascular disease was worse, emphasizing the need for prevention strategies to optimization cardiovascular risk factors (hypertension, diabetes, dyslipidemia) in cancer survivors.

    Article  PubMed  Google Scholar 

  9. Libby P. Inflammation in atherosclerosis. Nature. 2002;420:868–74.

    Article  CAS  PubMed  Google Scholar 

  10. Vendramini-Costa DB, Carvalho JE. Molecular link mechanisms between inflammation and cancer. Curr Pharm Des. 2012;18:3831–52.

    Article  CAS  PubMed  Google Scholar 

  11. Mantovani A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. Nature. 2008;454:436–44.

    Article  CAS  PubMed  Google Scholar 

  12. Whitlock MC, Yeboah J, Burke GL. Cancer and its association with the development of coronary artery calcification: an assessment from the multi-ethnic study of atherosclerosis. J Am Heart Assoc 2015;4e002533. In this study, the authors observed association between incident cancer and higher rates of new coronary artery calcium (CAC), a marker of subclinical atherosclerosis. These findings support the hypothesis that systemic effects such as increased inflammation occur concurrently and play a role in the development of cancer and atherosclerosis at the same time.

  13. Bair SM, Choueiri TK, Moslehi J. Cardiovascular complications associated with novel angiogenesis inhibitors: emerging evidence and evolving perspectives. Trends Cardiovasc Med. 2013;23:104–13.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Lee MS, Finch W, Mahmud E. Cardiovascular complications of radiotherapy. Am J Cardiol. 2013;112:1688–96.

    Article  PubMed  Google Scholar 

  15. Yeh ET, Bickford CL. Cardiovascular complications of cancer therapy: incidence, pathogenesis, diagnosis, and management. J Am Coll Cardiol. 2009;53:2231–47.

    Article  CAS  PubMed  Google Scholar 

  16. Hodgson DC. Hodgkin lymphoma: the follow-up of long-term survivors. Hematol Oncol Clin N Am. 2008;22:233–44.

    Article  Google Scholar 

  17. Hahn VS, Lenihan DJ, Ky B. Cancer therapy-induced cardiotoxicity: basic mechanisms and potential cardioprotective therapies. J Am Heart Assoc. 2014;3:665.

    Article  CAS  Google Scholar 

  18. Filopei J, Frishman W. Radiation-induced heart disease. Cardiol Rev. 2012;20:184–8.

    Article  PubMed  Google Scholar 

  19. Zhang S, Liu X, Bawa-Khalfe T, et al. Identification of the molecular basis of doxorubicin-induced cardiotoxicity. Nat Med. 2012;18:1639–42.

    Article  PubMed  CAS  Google Scholar 

  20. Swain SM, Whaley FS, Ewer MS. Congestive heart failure in patients treated with doxorubicin: a retrospective analysis of three trials. Cancer. 2003;97:2869–79.

    Article  CAS  PubMed  Google Scholar 

  21. Buzdar AU, Marcus C, Smith TL. Early and delayed clinical cardiotoxicity of doxorubicin. Cancer. 1985;55:2761–5.

    Article  CAS  PubMed  Google Scholar 

  22. Horenstein MS, Vander Heide RS, L’Ecuyer TJ. Molecular basis of anthracycline-induced cardiotoxicity and its prevention. Mol Genet Metab. 2000;71:436–44.

    Article  CAS  PubMed  Google Scholar 

  23. Octavia Y, Tocchetti CG, Gabrielson KL. Doxorubicin-induced cardiomyopathy: from molecular mechanisms to therapeutic strategies. J Mol Cell Cardiol. 2012;52:1213–25.

    Article  CAS  PubMed  Google Scholar 

  24. Zhang YW, Shi J, Li YJ, Wei L. Cardiomyocyte death in doxorubicin-induced cardiotoxicity. Arch Immunol Ther Exp (Warsz). 2009;57:435–45.

    Article  CAS  Google Scholar 

  25. Plana JC, Galderisi M, Barac A, et al. Expert consensus for multimodality imaging evaluation of adult patients during and after cancer therapy: a report from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2014;15:1063–93. These are current recommendations for cardiac imaging in patients before, during, and after cancer therapy. Echocardiography is the cornerstone in evaluation of cardiac structure and function in cancer patients and cancer survivors. These guidelines provide recommendations for initial assessment and follow-up imaging in patients undergoing cardiotoxic chemotherapy.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Bhave M, Akhter N, Rosen ST. Cardiovascular toxicity of biologic agents for cancer therapy. Oncology (Williston Park). 2014;28:482–90.

    Google Scholar 

  27. Zeglinski M, Ludke A, Jassal DS, Singal PK. Trastuzumab-induced cardiac dysfunction: a ‘dual-hit’. Exp Clin Cardiol. 2011;16:70–4.

    CAS  PubMed  PubMed Central  Google Scholar 

  28. Basavaraju SR, Easterly CE. Pathophysiological effects of radiation on atherosclerosis development and progression, and the incidence of cardiovascular complications. Med Phys. 2002;29:2391–403.

    Article  PubMed  Google Scholar 

  29. Altena R, Perik PJ, van Veldhuisen DJ. Cardiovascular toxicity caused by cancer treatment: strategies for early detection. Lancet Oncol. 2009;10:391–9.

    Article  CAS  PubMed  Google Scholar 

  30. Aoki S, Hayashi N, Abe O, et al. Radiation-induced arteritis: thickened wall with prominent enhancement on cranial MR images report of five cases and comparison with 18 cases of Moyamoya disease. Radiology. 2002;223:683–8.

    Article  PubMed  Google Scholar 

  31. Mathias D, Mitchel RE, Barclay M, et al. Low-dose irradiation affects expression of inflammatory markers in the heart of ApoE −/− mice. PLoS One. 2015;10:e0119661.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  32. Taunk NK, Haffty BG, Kostis JB. Radiation-induced heart disease: pathologic abnormalities and putative mechanisms. Front Oncol. 2015;5:39.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Mert M, Arat-Ozkan A, Ozkara A. Radiation-induced coronary artery disease. Z Kardiol. 2003;92:682–5.

    Article  CAS  PubMed  Google Scholar 

  34. Ranpura V, Hapani S, Chuang J. Risk of cardiac ischemia and arterial thromboembolic events with the angiogenesis inhibitor bevacizumab in cancer patients: a meta-analysis of randomized controlled trials. Acta Oncol. 2010;49:287–97.

    Article  CAS  PubMed  Google Scholar 

  35. Khakoo AY, Yeh ETH. Therapy insight: management of cardiovascular disease in patients with cancer and cardiac complications of cancer therapy. Nat Clin Prac Oncol. 2008;5:655–67.

    Article  CAS  Google Scholar 

  36. Chen XL, Lei YH, Liu CF, et al. Angiogenesis inhibitor bevacizumab increases the risk of ischemic heart disease associated with chemotherapy: a meta-analysis. PLoS One. 2013;8:e66721.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Arima Y, Oshima S, Noda K, et al. Sorafenib-induced acute myocardial infarction due to coronary artery spasm. J Cardiol. 2009;54:512–5.

    Article  PubMed  Google Scholar 

  38. de Forni M, Malet-Martino MC, Jaillais P, et al. Cardiotoxicity of high-dose continuous infusion fluorouracil: a prospective clinical study. J Clin Oncol. 1992;10:1795–801.

    PubMed  Google Scholar 

  39. Lejonc JL, Vernant JP, Macquin J. Myocardial infarction following vinblastine treatment. Lancet. 1980;2:692.

    Article  CAS  PubMed  Google Scholar 

  40. Mandel EM, Lewinski U, Djaldetti M. Vincristine-induced myocardial infarction. Cancer. 1975;36:1979–82.

    Article  CAS  PubMed  Google Scholar 

  41. Tsai HT, Marshall JL, Weiss SR, et al. Bevacizumab use and risk of cardiovascular adverse events among elderly patients with colorectal cancer receiving chemotherapy: a population-based study. Ann Oncol. 2013;24:1574–9.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Alter P, Herzum M, Soufi M. Cardiotoxicity of 5-fluorouracil. Cardiovasc Hematol Agents Med Chem. 2006;4:1–5.

    Article  CAS  PubMed  Google Scholar 

  43. Lee CK, Aeppli D, Nierengarten ME. The need for long-term surveillance for patients treated with curative radiotherapy for Hodgkin’s disease: University of Minnesota experience. Int J Radiat Oncol Biol Phys. 2000;48:169–79.

    Article  CAS  PubMed  Google Scholar 

  44. Heidenreich PA, Schnittger I, Strauss HW, et al. Screening for coronary artery disease after mediastinal irradiation for Hodgkin’s disease. J Clin Oncol. 2007;25:43–9.

    Article  PubMed  Google Scholar 

  45. Hanrahan EO, Gonzalez-Angulo AM, Giordano SH, et al. Overall survival and cause-specific mortality of patients with stage T1a, bN0M0 breast carcinoma. J Clin Oncol. 2007;25:4952–60.

    Article  PubMed  Google Scholar 

  46. Darby S, McGale P, Peto R. Mortality from cardiovascular disease more than 10 years after radiotherapy for breast cancer: nationwide cohort study of 90 000 Swedish women. BMJ. 2003;326:256–7.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Giordano SH, Kuo YF, Freeman JL. Risk of cardiac death after adjuvant radiotherapy for breast cancer. J Natl Cancer Inst. 2005;97:419–24.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Early Breast Cancer Trialists’ Collaborative G. Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10 801 women in 17 randomised trials. Lancet. 2011;378:1707–16.

    Article  Google Scholar 

  49. Hardenbergh PH, Munley MT, Bentel GC, et al. Cardiac perfusion changes in patients treated for breast cancer with radiation therapy and doxorubicin: preliminary results. Int J Radiat Oncol Biol Phys. 2001;49:1023–8.

    Article  CAS  PubMed  Google Scholar 

  50. Achenbach S, Moselewski F, Ropers D, et al. Detection of calcified and noncalcified coronary atherosclerotic plaque by contrast-enhanced, submillimeter multidetector spiral computed tomography: a segment-based comparison with intravascular ultrasound. Circulation. 2004;109:14–7.

    Article  PubMed  Google Scholar 

  51. Detrano R, Guerci AD, Carr JJ, et al. Coronary calcium as a predictor of coronary events in four racial or ethnic groups. N Engl J Med. 2008;358:1336–45.

    Article  CAS  PubMed  Google Scholar 

  52. Douglas PS, Hoffmann U, Patel MR, et al. Outcomes of anatomical versus functional testing for coronary artery disease. N Engl J Med. 2015;372:1291–300.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. Sangiorgi G, Rumberger JA, Severson A, et al. Arterial calcification and not lumen stenosis is highly correlated with atherosclerotic plaque burden in humans: a histologic study of 723 coronary artery segments using nondecalcifying methodology. J Am Coll Cardiol. 1998;31:126–33.

    Article  CAS  PubMed  Google Scholar 

  54. Yeboah J, McClelland RL, Polonsky TS, et al. Comparison of novel risk markers for improvement in cardiovascular risk assessment in intermediate-risk individuals. JAMA. 2012;308:788–95.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. Smith Jr SC. Multiple risk factors for cardiovascular disease and diabetes mellitus. Am J Med. 2007;120:S3–s11.

    Article  PubMed  Google Scholar 

  56. Bittencourt MS, Blaha MJ, Blankstein R, et al. Polypill therapy, subclinical atherosclerosis, and cardiovascular events-implications for the use of preventive pharmacotherapy: MESA (Multi-Ethnic Study of Atherosclerosis). J Am Coll Cardiol. 2014;63:434–43.

    Article  PubMed  Google Scholar 

  57. Blaha MJ, Budoff MJ, DeFilippis AP, et al. Associations between C-reactive protein, coronary artery calcium, and cardiovascular events: implications for the JUPITER population from MESA, a population-based cohort study. Lancet. 2011;378:684–92.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  58. Einstein AJ, Henzlova MJ, Rajagopalan S. Estimating risk of cancer associated with radiation exposure from 64-slice computed tomography coronary angiography. JAMA. 2007;298:317–23.

    Article  CAS  PubMed  Google Scholar 

  59. Hughes-Austin JM, Dominguez A, 3rd, Allison MA et al. Relationship of coronary calcium on standard chest CT scans with mortality. JACC Cardiovasc Imaging 2016;9:152–9. This study determined that CAC scores derived from non-cardiac scans correlated closely with CAC scores measured on dedicated ECG-gated scans.

  60. Kim YK, Sung YM, Cho SH. Reliability analysis of visual ranking of coronary artery calcification on low-dose CT of the thorax for lung cancer screening: comparison with ECG-gated calcium scoring CT. Int J Cardiovasc Imaging. 2014;30 Suppl 2:81–7.

    Article  PubMed  Google Scholar 

  61. Jacobs PC, Gondrie MJ, van der Graaf Y, et al. Coronary artery calcium can predict all-cause mortality and cardiovascular events on low-dose CT screening for lung cancer. AJR Am J Roentgenol. 2012;198:505–11.

    Article  PubMed  Google Scholar 

  62. Budoff MJ, Dowe D, Jollis JG, et al. Diagnostic performance of 64-multidetector row coronary computed tomographic angiography for evaluation of coronary artery stenosis in individuals without known coronary artery disease: results from the prospective multicenter ACCURACY (Assessment by Coronary Computed Tomographic Angiography of Individuals Undergoing Invasive Coronary Angiography) trial. J Am Coll Cardiol. 2008;52:1724–32.

    Article  PubMed  Google Scholar 

  63. Meijboom WB, Meijs MF, Schuijf JD, et al. Diagnostic accuracy of 64-slice computed tomography coronary angiography: a prospective, multicenter, multivendor study. J Am Coll Cardiol. 2008;52:2135–44.

    Article  PubMed  Google Scholar 

  64. Miller JM, Rochitte CE, Dewey M, et al. Diagnostic performance of coronary angiography by 64-row CT. N Engl J Med. 2008;359:2324–36.

    Article  CAS  PubMed  Google Scholar 

  65. Bittencourt MS, Hulten E, Ghoshhajra B, et al. Prognostic value of nonobstructive and obstructive coronary artery disease detected by coronary computed tomography angiography to identify cardiovascular events. Circ Cardiovasc Imaging. 2014;7:282–91.

    Article  PubMed  Google Scholar 

  66. Bamberg F, Sommer WH, Hoffmann V, et al. Meta-analysis and systematic review of the long-term predictive value of assessment of coronary atherosclerosis by contrast-enhanced coronary computed tomography angiography. J Am Coll Cardiol. 2011;57:2426–36.

    Article  PubMed  Google Scholar 

  67. Hulten EA, Carbonaro S, Petrillo SP. Prognostic value of cardiac computed tomography angiography: a systematic review and meta-analysis. J Am Coll Cardiol. 2011;57:1237–47.

    Article  PubMed  Google Scholar 

  68. CT coronary angiography in patients with suspected angina due to coronary heart disease (SCOT-HEART): an open-label, parallel-group, multicentre trial. The Lancet 2015;385:2383–2391.

  69. Travis LB, Ng AK, Allan JM, et al. Second malignant neoplasms and cardiovascular disease following radiotherapy. Health Phys. 2014;106:229–46.

    Article  CAS  PubMed  Google Scholar 

  70. Daniels LA, Krol AD, de Graaf MA, et al. Screening for coronary artery disease after mediastinal irradiation in Hodgkin lymphoma survivors: phase II study of indication and acceptancedagger. Ann Oncol. 2014;25:1198–203.

    Article  CAS  PubMed  Google Scholar 

  71. Kupeli S, Hazirolan T, Varan A, et al. Evaluation of coronary artery disease by computed tomography angiography in patients treated for childhood Hodgkin’s lymphoma. J Clin Oncol. 2010;28:1025–30.

    Article  PubMed  Google Scholar 

  72. Rademaker J, Schoder H, Ariaratnam NS, et al. Coronary artery disease after radiation therapy for Hodgkin’s lymphoma: coronary CT angiography findings and calcium scores in nine asymptomatic patients. AJR Am J Roentgenol. 2008;191:32–7.

    Article  PubMed  Google Scholar 

  73. Girinsky T, M’Kacher R, Lessard N, et al. Prospective coronary heart disease screening in asymptomatic Hodgkin lymphoma patients using coronary computed tomography angiography: results and risk factor analysis. Int J Radiat Oncol Biol Phys. 2014;89:59–66. This study investigated the use of coronary CTA for the detection and evaluation of coronary artery disease in patients with Hodgkin’s lymphoma after treatment with chest radiation. The observations from this study suggest that coronary CTA could be an effective, simple and noninvasive modality for identification of CAD in asymptomatic cancer patients. Either preventative or curative treatment in patients at high risk of CAD could improve overall cancer outcomes.

    Article  PubMed  Google Scholar 

  74. Orzan F, Brusca A. Radiation-induced constrictive pericarditis. Associated cardiac lesions, therapy and follow-up. G Ital Cardiol. 1994;24:817–23.

    CAS  PubMed  Google Scholar 

  75. Fukada J, Shigematsu N, Ohashi T, et al. Pericardial and pleural effusions after definitive radiotherapy for esophageal cancer. J Radiat Res. 2012;53:447–53.

    Article  PubMed  Google Scholar 

  76. Veinot JP, Edwards WD. Pathology of radiation-induced heart disease: a surgical and autopsy study of 27 cases. Hum Pathol. 1996;27:766–73.

    Article  CAS  PubMed  Google Scholar 

  77. Jaworski C, Mariani JA, Wheeler G, Kaye DM. Cardiac complications of thoracic irradiation. J Am Coll Cardiol. 2013;61:2319–28.

    Article  PubMed  Google Scholar 

  78. Dazzi H, Kaufmann K, Follath F. Anthracycline-induced acute cardiotoxicity in adults treated for leukaemia: analysis of the clinico-pathological aspects of documented acute anthracycline-induced cardiotoxicity in patients treated for acute leukaemia at the University Hospital of Zürich, Switzerland, between 1990 and 1996. Ann Oncol. 2001;12:963–6.

    Article  CAS  PubMed  Google Scholar 

  79. Katayama M, Imai Y, Hashimoto H, et al. Fulminant fatal cardiotoxicity following cyclophosphamide therapy. J Cardiol. 2009;54:330–4.

    Article  PubMed  Google Scholar 

  80. van Leeuwen-Segarceanu EM, Bos WJ, Dorresteijn LD, et al. Screening Hodgkin lymphoma survivors for radiotherapy induced cardiovascular disease. Cancer Treat Rev. 2011;37:391–403.

    Article  PubMed  Google Scholar 

  81. Bovelli D, Plataniotis G, Roila F, Group EGW. Cardiotoxicity of chemotherapeutic agents and radiotherapy-related heart disease: ESMO Clinical Practice Guidelines. Ann Oncol. 2010;21 Suppl 5:v277–82.

    Article  PubMed  Google Scholar 

  82. Bogaert J, Francone M. Pericardial disease: value of CT and MR imaging. Radiology. 2013;267:340–56.

    Article  PubMed  Google Scholar 

  83. Alter P, Figiel JH, Rupp TP. MR, CT, and PET imaging in pericardial disease. Heart Fail Rev. 2013;18:289–306.

    Article  CAS  PubMed  Google Scholar 

  84. Klein AL, Abbara S, Agler DA, et al. American Society of Echocardiography clinical recommendations for multimodality cardiovascular imaging of patients with pericardial disease: endorsed by the Society for Cardiovascular Magnetic Resonance and Society of Cardiovascular Computed Tomography. J Am Soc Echocardiogr. 2013;26:965–1012. e15.

    Article  PubMed  Google Scholar 

  85. Hull MC, Morris CG, Pepine CJ. Valvular dysfunction and carotid, subclavian, and coronary artery disease in survivors of Hodgkin lymphoma treated with radiation therapy. JAMA. 2003;290:2831–7.

    Article  CAS  PubMed  Google Scholar 

  86. Schellong G, Riepenhausen M, Bruch C, et al. Late valvular and other cardiac diseases after different doses of mediastinal radiotherapy for Hodgkin disease in children and adolescents: report from the longitudinal GPOH follow-up project of the German-Austrian DAL-HD studies. Pediatr Blood Cancer. 2010;55:1145–52.

    Article  PubMed  Google Scholar 

  87. Brosius 3rd FC, Waller BF, Roberts WC. Radiation heart disease. Analysis of 16 young (aged 15 to 33 years) necropsy patients who received over 3,500 rads to the heart. Am J Med. 1981;70:519–30.

    Article  PubMed  Google Scholar 

  88. Ong DS, Aertker RA, Clark AN, et al. Radiation-associated valvular heart disease. J Heart Valve Dis. 2013;22:883–92.

    PubMed  Google Scholar 

  89. Cutter DJ, Schaapveld M, Darby SC, et al. Risk of valvular heart disease after treatment for Hodgkin lymphoma. J Natl Cancer Inst. 2015;107.

  90. Wethal T, Lund MB, Edvardsen T, et al. Valvular dysfunction and left ventricular changes in Hodgkin’s lymphoma survivors. A longitudinal study. Br J Cancer. 2009;101:575–81.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  91. Tamura A, Takahara Y, Mogi K. Radiation-induced valvular disease is the logical consequence of irradiation. Gen Thorac Cardiovasc Surg. 2007;55:53–6.

    Article  PubMed  Google Scholar 

  92. Cutter DJ, Schaapveld M, Darby SC, et al. Risk of valvular heart disease after treatment for Hodgkin lymphoma. J Natl Cancer Inst. 2015;107:djv008.

    Article  PubMed  PubMed Central  Google Scholar 

  93. Carlson RG, Mayfield WR, Normann S, Alexander JA. Radiation-associated valvular disease. Chest. 1991;99:538–45.

    Article  CAS  PubMed  Google Scholar 

  94. Baumgartner H. Aortic stenosis: medical and surgical management. Heart. 2005;91:1483–8.

    Article  PubMed  PubMed Central  Google Scholar 

  95. Myrehaug S, Pintilie M, Tsang R, et al. Cardiac morbidity following modern treatment for Hodgkin lymphoma: supra-additive cardiotoxicity of doxorubicin and radiation therapy. Leuk Lymphoma. 2008;49:1486–93.

    Article  CAS  PubMed  Google Scholar 

  96. Feuchtner G. Imaging of cardiac valves by computed tomography. Scientifica. 2013;2013:270579.

    Article  PubMed  PubMed Central  Google Scholar 

  97. Boxt LM. CT of valvular heart disease. Int J Cardiovasc Imaging. 2005;21:105–13.

    Article  PubMed  Google Scholar 

  98. Cueff C, Serfaty JM, Cimadevilla C, et al. Measurement of aortic valve calcification using multislice computed tomography: correlation with haemodynamic severity of aortic stenosis and clinical implication for patients with low ejection fraction. Heart. 2011;97:721–6.

    Article  PubMed  Google Scholar 

  99. Cowell SJ, Newby DE, Burton J, et al. Aortic valve calcification on computed tomography predicts the severity of aortic stenosis. Clin Radiol. 2003;58:712–6.

    Article  CAS  PubMed  Google Scholar 

  100. Clavel MA, Pibarot P, Messika-Zeitoun D, et al. Impact of aortic valve calcification, as measured by MDCT, on survival in patients with aortic stenosis: results of an international registry study. J Am Coll Cardiol. 2014;64:1202–13.

    Article  PubMed  PubMed Central  Google Scholar 

  101. Chitsaz S, Gundiah N, Blackshear C, et al. Correlation of calcification on excised aortic valves by micro-computed tomography with severity of aortic stenosis. J Heart Valve Dis. 2012;21:320–7.

    PubMed  Google Scholar 

  102. Blanke P, Schoepf UJ, Leipsic JA. CT in transcatheter aortic valve replacement. Radiology. 2013;269:650–69.

    Article  PubMed  Google Scholar 

  103. Apfaltrer P, Henzler T, Blanke P. Computed tomography for planning transcatheter aortic valve replacement. J Thorac Imaging. 2013;28:231–9.

    Article  PubMed  Google Scholar 

  104. Litmanovich DE, Ghersin E, Burke DA. Imaging in Transcatheter Aortic Valve Replacement (TAVR): role of the radiologist. Insights Imaging. 2014;5:123–45.

    Article  PubMed  PubMed Central  Google Scholar 

  105. Achenbach S, Delgado V, Hausleiter J. SCCT expert consensus document on computed tomography imaging before transcatheter aortic valve implantation (TAVI)/transcatheter aortic valve replacement (TAVR). J Cardiovasc Comput Tomogr. 2012;6:366–80.

    Article  PubMed  Google Scholar 

  106. Blanke P, Dvir D, Cheung A, et al. Mitral annular evaluation with CT in the context of transcatheter mitral valve replacement. JACC Cardiovasc Imaging. 2015;8:612–5.

    Article  PubMed  Google Scholar 

  107. Koo HJ, Yang DH, Oh SY, et al. Demonstration of mitral valve prolapse with CT for planning of mitral valve repair. Radiographics. 2014;34:1537–52.

    Article  PubMed  Google Scholar 

  108. De Backer O, Piazza N, Banai S, et al. Percutaneous transcatheter mitral valve replacement: an overview of devices in preclinical and early clinical evaluation. Circ Cardiovasc Interv. 2014;7:400–9.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

Dr. Ferencik was supported by a research grant from the American Heart Association (Fellow to Faculty Award 13FTF16450001).

Author information

Authors and Affiliations

  1. Knight Cardiovascular Institute, Oregon Health and Science University, 3180 Sam Jackson Park Rd., Mail Code UHN62, Portland, OR, 97239, USA

    Barbora Pitekova, Sriram Ravi, Shimoli V. Shah, Stephen Heitner & Maros Ferencik

  2. Institute of Pathological Physiology, Faculty of Medicine, Comenius University, Spitalska 24, 813 72, Bratislava, Slovakia

    Barbora Pitekova & Beata Mladosievicova

Authors
  1. Barbora Pitekova
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sriram Ravi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shimoli V. Shah
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Beata Mladosievicova
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Stephen Heitner
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Maros Ferencik
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Maros Ferencik.

Ethics declarations

Conflict of Interest

Barbora Pitekova, Sriram Ravi, Shimoli V. Shah, Beata Mladosievicova, and Maros Ferencik declare that they have no conflict of interest. Stephen Heitner has received research funding from Millennium Pharmaceuticals, and has done consulting work for Amgen and Takeda.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Cardio-Oncology

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pitekova, B., Ravi, S., Shah, S.V. et al. The Role of Imaging with Cardiac Computed Tomography in Cardio-Oncology Patients. Curr Cardiol Rep 18, 87 (2016). https://doi.org/10.1007/s11886-016-0768-z

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11886-016-0768-z

Keywords

Search

Navigation