Clinical applications of PET imaging for evaluating treatment-induced vascular toxicity in oncology

Purpose of review Vascular toxicity resulting from cancer and its treatment remains a largely uncharacterized and minimally treated pathology. This review highlights ongoing developments and applications of PET imaging for noninvasive characterization of cancer-associated vascular toxicity and discusses the potential prognostic value of PET imaging for predicting adverse cardiovascular outcomes in patients with cancer. Recent findings Numerous clinical investigations have used PET imaging to evaluate vascular inflammation/toxicity in patients undergoing or completing cancer therapies, including chemotherapy, immune checkpoint inhibitors, and radiation therapy. The most widely utilized PET radionuclide for noninvasively detecting vascular toxicity in clinical oncology has been fluorine-18-fluorodeoxyglucose, which has demonstrated promising associations with disease severity and clinical outcomes. Emerging radionuclides continue to be developed for targeting immune cells and may increase the sensitivity and specificity of PET imaging for detecting vascular toxicity associated with cancers and their treatment. Summary The use of PET imaging for noninvasive detection and quantification of cancer treatment-associated vascular toxicity continues to evolve and could provide a unique approach for predicting risk of adverse cardiovascular outcomes in various forms of cancer and treatment.