Imaging’s Role in Helping Earlier Detection of Cardio Complications in Cancer Treatment

2017-05-09
 

Imaging clinician examining cardiology imagesThe cancer survival rate tripled between 1971 and 2001, a testament to advancements in cancer detection and treatment. While this certainly is great news, aggressive treatment is not without risk. During the same time period, a noted increase in cardiovascular diseases among cancer survivors has been identified.

This increase threatens to offset some of the gains realized in cancer-related treatments. Early detection of cardiotoxicity is important to lessen the chance of having lasting cardiac effects during or after the cancer treatment.

Cardiology and Oncology are working closely together for better outcomes among patients being treated for various forms and stages of cancer. Helping patients complete cancer treatments without developing any acute or chronic heart problems requires a multidisciplinary approach.

The European Society of Cardiology tackles the issue of cardiac toxicity of cancer treatments in a new position paper in the European Heart Journal. Jose Luis Zamorano, chairman of the society’s Committee for Practice Guidelines, stresses the need to consider patients as more than their cancers.

“We need to treat the whole person because at the end of the day the patient is not a cancer, but is a person with a heart,” Zamorano wrote. “Many patients today do not die due to the cancer but from cardiac complications related to the treatment. They need to be monitored by a multidisciplinary team to prevent and treat cardiac complications.”

Cardiology Imaging’s Role in Cardiac Care

Chemotherapy agents such as anthracyclines, taxanes and trastuzumabs are used by oncologists to restrict blood supply to either destroy or slow down tumor growth. However, these drugs can also disrupt coronary artery distribution and or weaken the myocardium (heart muscle).

Left ventricular ejection fraction has been the standard to monitor a patient’s systolic function at baseline, during treatment and upon completion of treatment of cardiotoxic drugs. However, the problem is that once the LVEF has decreased, it is often too late to reverse the effects and damage caused by these drugs. The need to use more specific markers that are able to give us information of subclinical myocardial deteriorations (non- visual changes in cardiac systolic function) long before the visual decrease in LVEF are needed.

A 2012 research paper showed that global and/or regional strain data has a higher sensitivity to observe subclinical deteriorations. Cardiology imaging may now be able to communicate non-visual changes to heart function to Oncology before lasting damage has been caused. This may also help guide treatment and thus avoid cardiac side effects caused by anthracycline treatment. As more studies on advanced imaging techniques show their importance in providing quality care vendor-neutral analysis methods such as those provided by TomTec Imaging Systems will be crucial for widespread adoption and standards.

Seamless access to quantification tools from within the CVIS is critical to successfully implement a cardio-oncology program. When fully integrated into your clinical workflow, vendor neutral and highly reproducible solutions for auto quantification of ejection fraction and strain imaging can offer the ability to derive consistent, true and reliable clinical markers for cardio-oncology. This workflow also serves to establish a consistent environment, as all analysis can be performed using the same software, thus eliminating the concern of different levels of software and or multi-vendor analysis.

Learn more about our single database CVIS solution on our web site, or request a meeting or demo at HRS 2017 in Chicago, Illinois.

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