The application of 18F-fluorodeoxyglucose positron emission tomography/computed tomography for detecting cardiotoxicity associated with anthracyclines: a systematic review

Abstract

Anthracyclines (ATCs) are crucial in cancer therapy; however, their use poses a significant risk of cardiotoxicity and is often underdiagnosed by traditional methods. This systematic review evaluated the efficacy of F-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG PET/CT) in the early detection of cardiotoxicity associated with ATC. A comprehensive search of the databases from January 2018 to March 2025 yielded seven relevant studies. These findings indicate that increased myocardial uptake of F-18-FDG correlates with metabolic alterations indicative of cardiotoxicity in patients undergoing ATC therapy. This suggests that F-18-FDG PET/CT can serve as a valuable early diagnostic marker. This review highlights the potential of F-18-FDG PET/CT to enhance monitoring and management strategies for at-risk patients, ultimately improving cancer treatment outcomes. As the integration of this imaging modality into clinical practice could reshape cardiotoxicity assessment, further research is warranted to validate these findings and refine the guidelines for its application in oncology.