New recommendations published for cardiac CT use in cardio-oncology

ARLINGTON, VA (Sept. 16, 2022) – The Society of Cardiovascular Computed Tomography (SCCT) released an expert consensus document providing guidance on the use of cardiac CT (CCT) in the care of cardio-oncology patients.

Published in Journal of Cardiovascular Computed Tomography (JCCT) and endorsed by the International Cardio-Oncology Society (ICOS), the statement was written with the intent of filling gaps in recommendations from prior consensus statements and guidelines in regards to the use of CCT in cardio-oncology.

“The importance of this document is that it provides expert consensus recommendations in cancer patients and survivors, an area with paucity of data and lack of guidance by guidelines and standards in the field of cardio-oncology,” explained Juan Lopez-Mattei, MD, FSCCT, lead author and Medical Director of Cardiac Imaging at Lee Health Heart and Vascular Institute in Fort Myers, Florida.

Cancer patients and survivors have significantly increased cardiovascular risk when compared with non-cancer patients, he said. “The intentions of many of our recommendations are to be able to identify subclinical atherosclerotic cardiovascular disease (ASCVD) in these patients and to initiate promptly and appropriately preventive treatments.”

The guidance provides multimodality recommendations, with contributions from cardio-oncologists, multimodality cardiovascular imaging experts, cardiac CT experts, radiologists and cancer medicine experts – including radiation oncologists and medical oncologists.

The writing group places emphasis on reviewing prior recent non-gated chest CT scans if available to assess for subclinical presence of ASCVD and further cardiovascular risk assessment (qualitative or quantitative) using the CAC-Data Reporting System (CAC-DRS).

According to Lopez-Mattei, the key takeaway for the clinical cardiologist, oncologist and radiation oncologist is to use pre-existing non-gated chest CT scans from cancer patients and survivors to assess for the presence of coronary artery calcium (CAC), and either promptly treat or refer to a cardio-oncologist.

For radiologists and nuclear medicine physicians, the guidance advises to start mentioning presence or absence of CAC in reports, and to start considering assessment of CAC burden quantitatively or qualitatively in non-contrast non-gated scans (preferably by CAC-DRS).

Read the consensus document in JCCT.

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About the Society of Cardiovascular Computed Tomography

Founded in 2005, the Society of Cardiovascular Computed Tomography (SCCT) is the international professional society devoted to improving health outcomes through effective use of cardiovascular computed tomography (CCT). SCCT is a community of physicians, scientists and technologists from over 85 countries advocating for access, research, education and clinical excellence in the use of CCT. For more information, please visit www.SCCT.org.

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