Summary of Cardiac Computed Tomographic Imaging in Cardio-Oncology: An Expert Consensus Document of the Society of Cardiovascular Computed Tomography

Purpose: The purpose of this document is to develop a summary of recommendations from the “Cardiac Computed Tomographic Imaging in Cardio-Oncology: An Expert Consensus Document of the Society of Cardiovascular Computed Tomography (SCCT)” document and provide commentary on key recommendations that are relevant to radiation oncology. Methods: In July 2019, the SCCT convened a multidisciplinary panel of experts to develop a consensus document based on a literature search and a formal consensus process, which was separately published in 2022. A new panel consisting of the radiation oncologist from the original guideline and additional radiation oncologists was formed to address SCCT recommendations and their implications for radiation oncology. The SCCT consensus document included 6 core sections. Two of these sections were identified as particularly relevant to radiation oncologists. These include evaluation of shared risk factors and role of cardiac computed tomography in risk stratification of patients with cancer (section 1) and the role of cardiac computed tomography in the evaluation of the effects of radiation therapy (section 4). These recommendations are summarized, with additional commentary on the role of radiation oncologists as individual practitioners and radiation oncology practices as a whole in evaluation of coronary artery calcifications on computed tomography images; assessment of the effects of radiation therapy on cardiovascular risk after treatment; and management of patients at elevated risk of cardiovascular sequelae of treatment. Radiation oncologists should be aware of the recommendations in the SCCT consensus document and consider those elements that relate to their practice. This summary document calls attention to the key roles and limitations of radiation oncologists and radiation oncology practices in managing cardiotoxicity risk and highlights the need for ongoing study on the effects of radiation therapy on the heart, cardiac substructures, and long-term risk of cardiotoxicity related to treatment.