Imaging Features of Therapeutic Drug-Induced Disease: Part II

As survival rate continues to increase for patients with childhood and adult malignancies, it is important to detect disease recurrence and to find the potential complication that occurs after treatment with oncologic medication and therapeutic radiation. The most common side effect of the anthracycline drug is its cardiotoxic effect which will give the patient a decline in ejection fraction and may result in dilated cardiomyopathy. The use of isotope scan and FDG-PET exam plays an important role in diagnosis of this subclinical cardiac dysfunction. Other less common cardiotoxic side effect of chemotherapeutic medications include: arrhythmia, myocarditis, coronary artery disease, tamponade, pericarditis, and pericardial effusion. Radiation therapy can also lead to cardiotoxicity when the heart or pericardium is included in the radiation porta. Radiation-induced conditions include: pericardial disease, coronary artery disease, valvular disease, and cardiomyopathy. Many of these side effects may remain asymptomatic until late in the course of the disease and may be detected earlier. With the use of appropriate imaging modalities, radiologists should be familiar with the current knowledge and pathophysiology of these cardiac complications.