Clinical application and research advances of positron emission tomography molecular imaging in immune checkpoint inhibitor-associated myocarditis

Immunotherapy, represented by immune checkpoint inhibitors (ICIs), has revolutionized cancer treatment paradigms yet has simultaneously posed significant challenges due to various immune-related adverse events. Among these, ICI-associated myocarditis-a rare but potentially fatal complication that severely impacts long-term patient prognosis-makes early diagnosis and risk stratification crucial. However, its highly heterogeneous and insidiously progressive clinical presentation challenges timely and accurate detection by conventional diagnostic methods, highlighting an urgent clinical need for more effective approaches. Positron emission tomography (PET) molecular imaging, by targeting specific pathophysiological processes, holds great potential for the noninvasive diagnosis and monitoring of this disease. Ongoing advances in novel probes and imaging technologies may further improve the capability of PET to characterize key mechanisms of ICI-associated myocarditis, providing a unique imaging window for early and precise intervention. Based on current clinical evidence and research findings, this article elaborates on the application value of PET molecular imaging in the clinical management of ICI-associated myocarditis and summarizes recent research progress, aiming to inform future clinical practice and research.