SCCT Publishes New Recommendations for Cardiac CT in Cardio-Oncology Patients

September 16, 2022—The Society of Cardiovascular Computed Tomography (SCCT) announced the release of an expert consensus statement providing guidance on the use of cardiac CT in the care of cardio-oncology patients.

The statement by Juan Lopez-Mattei, MD, et al was published online in SCCT's Journal of Cardiovascular Computed Tomography. It is endorsed by the International Cardio-Oncology Society.

The statement was written with the intent of filling gaps in recommendations from previous consensus statements and guidelines about the use of cardiac CT in cardio-oncology, noted the SCCT press release.

"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," commented Dr. Lopez-Mattei in the SCCT press release.

Dr. Lopez-Mattei, who is Medical Director of Cardiac Imaging at Lee Health Heart and Vascular Institute in Fort Myers, Florida, further noted that cancer patients and survivors have significantly increased cardiovascular risk when compared with noncancer patients.

He stated, "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 SCCT press release advised that 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 previous recent nongated 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 nongated 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 nongated scans (preferably by CAC-DRS).