State-of-the-Art Multimodality Imaging in Cardio-Oncology

By Daniel Addison, M.D.

Associate Professor of Internal Medicine
Audre and Bernard Rapoport Chair in Cardiovascular Research

Advances in cancer therapeutics have led to dramatic improvements in survival, now reaching nearly 20 million patients and rising. However, cardiovascular toxicities have become an increasingly common but important limitation to effective cancer therapy. Over the past decade, advances in cardiovascular imaging have improved our ability to detect, monitor, and prognosticate cardiovascular disease in patients with cancer. Despite these advances, the optimal uses of these contemporary multimodality cardiac imaging tools in patients with comorbid cancer are not well known in everyday clinical practice. We sought to address this gap in a recent AHA statement I chaired on the role of cardiovascular imaging in contemporary cardio-oncology patients.

At #AHA 2025, I moderated a session addressing the role of echocardiography, cardiac CT, cardiac MRI, nuclear imaging/PET, and emerging molecular imaging strategies in identifying and managing cardiovascular disease among patients with cancer. Specific scenarios included appropriate imaging of immune checkpoint inhibitor (ICI) myocarditis, microvascular disease, cardiac masses/thrombi, and optimal follow-up times for imaging after completion of anticancer therapy. Another topic included growing data on the potential uses of targeted molecular tracers in identifying brewing cardiotoxicity by CV imaging. Panelists discussed current best practices and the field’s expected future directions. Together with growing understanding of cardiotoxicity, these imaging approaches improve the cardiovascular management of patients treated with cancer therapies.