Cardiac imaging methods for chemotherapy-related cardiotoxicity screening and related radiation exposure: Current practice and trends

Background: Radiation exposure is a serious concern with usage of serial multigated acquisition (MUGA) scans (7.8mSv/study) for chemotherapy-related cardiotoxicity (CRC) screening. The current practice with respect to the imaging modalities chosen for cardiotoxicity screening and related radiation exposure has not been studied. Materials and Methods: We performed a serial cross-sectional study from 2011 to 2014, evaluating the relative usage of the three imaging modalities for CRC screening. Results: MUGA scan usage decreased from 30.4% to 16.7%, echocardiogram (Echo) utilization increased from 68.7% to 80.4% and cardiac magnetic resonance (CMR) usage increased from 0.9% to 2.9% in the 4-year period. Estimated total radiation exposure and secondary cancer risk can increase significantly in certain subgroups when MUGA scan is employed for serial cardiac imaging. Conclusion: Increased awareness of radiation risks from MUGA, as well as increasing focus on early detection of cardiotoxicity using Echo and CMR, are possible reasons behind the observed trends.