MR first pass perfusion of benign and malignant cardiac tumours—significant differences and diagnostic accuracy

Bauner, Kerstin; Sourbron, Steven; Picciolo, M.; Schmitz, C; Theisen, Daniel; Sandner, Thilo; Reiser, Maximilian; Huber, Armin

doi:10.1007/s00330-011-2245-9

Cited by 15 publications

(3 citation statements)

References 46 publications

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“…Malignant tumors appear on MRI as large, non-tipped masses with irregular, lobulated morphology that may invade the myocardium, pericardium, and adjacent extracardiac structures and are poorly demarcated from surrounding tissues (14). Enhanced MRI can identify the nature of cardiac tumors using first perfusion differences (16). PET/CT can differentially diagnose between benign and malignant cardiac tumors using the difference in cardiac or pericardial uptake of 2-[18F]-fluoro-2-deoxy-D-glucose (2-[18F]-fluoro-2-deoxy-D-glucose, FDG) (17,18).…”

Section: Discussionmentioning

confidence: 99%

Percutaneous ultrasound-guided core needle biopsy for the diagnosis of cardiac tumors: Optimizing the treatment strategy for patients with intermural and pericardial cardiac tumors

et al. 2022

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ObjectiveThe aims of this study are to investigate the clinical value and practical safety of ultrasound-guided percutaneous core needle biopsy on diagnosing cardiac tumor and to discuss the treatment strategy for cardiac intermural and pericardial tumors.MethodsThe clinical data were retrospectively collected for patients with intermural and pericardial cardiac tumors. The patients were divided into groups of surgical resection, surgical resection after obtaining pathological tissue by PUS-CNB, and/or radiotherapy according to the treatment modality. Ultrasound-guided aspiration biopsy was divided into cardiac tumor biopsy and extracardiac lesion biopsy according to patient conditions. The surgical time was recorded, and the safety and clinical application value of PUS-CNB for the diagnosis of cardiac tumors were evaluated in terms of complications and satisfaction with pathological sampling.ResultsA total of 18 patient cases were collected, and PUS-CNB of cardiac tumors was performed in 8 cases, with sampling times averaging 15.6 ± 3.0 min. Four cases of cardiac tumors combined with extracardiac tumors were biopsied, with puncture times averaging 13.0 ± 2.9 min. All 12 biopsied patients had no postoperative complications. Except for 1 failed biopsy, the biopsies were successful and the pathological results were consistent with the clinical diagnosis with a satisfaction rate of 91.7%. Except for two cases of surgical resection, the rest were considered for conservative treatment. Surgical resection and/or biopsy were performed in six cases, and two cases were aggravated after surgery. The final pathology of all 17 cardiac tumors was malignant.ConclusionPUS-CNB is safe and effective, providing a simple and undemanding method for accurate diagnosis of cardiac intermural and pericardial tumors while avoiding unnecessary open-heart surgery.

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Section: Discussionmentioning

confidence: 99%

Percutaneous ultrasound-guided core needle biopsy for the diagnosis of cardiac tumors: Optimizing the treatment strategy for patients with intermural and pericardial cardiac tumors

et al. 2022

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“…Traditional T1 and T2 weighted images (with or without fat suppression) provide qualitative information on mass composition, however, T2 weighted images are susceptible to motion artifacts, slow flow, and signal intensity variability [ 14 ]. First pass perfusion evaluates tumor vascularity, which can help to differentiate between benign and malignant tumors [ 15 ]. The presence and pattern of late gadolinium enhancement (LGE) in the tumor could represent vascularity and necrosis and has been shown to be able to differentiate neoplasm from thrombus, as well as to predict survival [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Multiparametric mapping by cardiovascular magnetic resonance imaging in cardiac tumors

Yue

Wan

et al. 2023

Journal of Cardiovascular Magnetic Resonance

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Background There is a paucity of quantitative measurements of cardiac tumors and myocardium using parametric mapping techniques. This study aims to explore quantitative characteristics and diagnostic performance of native T1, T2, and extracellular volume (ECV) values of cardiac tumors and left ventricular (LV) myocardium. Methods Patients with suspected cardiac tumors who underwent cardiovascular magnetic resonance (CMR) between November 2013 and March 2021 were prospectively enrolled. The diagnoses of primary benign or malignant tumors were based on pathologic findings if available, comprehensive medical history evaluations, imaging, and long-term follow-up data. Patients with pseudo-tumors, cardiac metastasis, primary cardiac diseases, and prior radiotherapy or chemotherapy were excluded. Multiparametric mapping values were measured on both cardiac tumors and the LV myocardium. Statistical analyses were performed using independent-samples t-test, receiver operating characteristic, and Bland–Altman analyses. Results A total of 80 patients diagnosed with benign (n = 54), or primary malignant cardiac tumors (n = 26), and 50 age and sex-matched healthy volunteers were included. Intergroup differences in the T1 and T2 values of cardiac tumors were not significant, however, patients with primary malignant cardiac tumors showed significantly higher mean myocardial T1 values (1360 ± 61.4 ms) compared with patients with benign tumors (1259.7 ± 46.2 ms), and normal controls (1206 ± 44.0 ms, all P < 0.05) at 3 T. Patients with primary malignant cardiac tumors also showed significantly higher mean ECV (34.6 ± 5.2%) compared with patients with benign (30.0 ± 2.5%) tumors, and normal controls (27.3 ± 3.0%, all P < 0.05). For the differentiation between primary malignant and benign cardiac tumors, the mean myocardial native T1 value showed the highest efficacy (AUC: 0.919, cutoff value: 1300 ms) compared with mean ECV (AUC: 0.817) and T2 (AUC: 0.619) values. Conclusion Native T1 and T2 of cardiac tumors showed high heterogeneity, while myocardial native T1 values in primary malignant cardiac tumors were elevated compared to patients with benign cardiac tumors, which may serve as a new imaging marker for primary malignant cardiac tumors.

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“…To overcome these limitations, T2 relaxation time mapping was suggested to provide a reliable and objective assessment of free water content (6,7). First pass perfusion assesses vascularity of the tumor (8). Late gadolinium enhancement (LGE) can identify localized areas of fibrosis but performs poorly in diffuse fibrosis, for which T1 relaxation time mapping and ECV measurements provide objective, quantitative information (9,10).…”

Section: Introductionmentioning

confidence: 99%

Cardiac Myxomas Show Elevated Native T1, T2 Relaxation Time and ECV on Parametric CMR

Nasser¹,

Doeblin

Doltra

et al. 2020

Front. Cardiovasc. Med.

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Introduction: While cardiac tumors are rare, their identification and differentiation has wide clinical implications. Recent cardiac magnetic resonance (CMR) parametric mapping techniques allow for quantitative tissue characterization. Our aim was to examine the range of values encountered in cardiac myxomas in correlation to histological measurements. Methods and Results: Nine patients with histologically proven cardiac myxomas were included. CMR (1.5 Tesla, Philips) including parametric mapping was performed in all patients pre-operatively. All data are reported as mean ± standard deviation. Compared to myocardium, cardiac myxomas demonstrated higher native T1 relaxation times (1,554 ± 192 ms vs. 1,017 ± 58 ms, p < 0.001), ECV (46.9 ± 13.0% vs. 27.1 ± 2.6%, p = 0.001), and T2 relaxation times (209 ± 120 ms vs. 52 ± 3 ms, p = 0.008). Areas with LGE showed higher ECV than areas without (54.3 ± 17.8% vs. 32.7 ± 18.6%, p = 0.042), with differences in native T1 relaxation times (1,644 ± 217 ms vs. 1,482 ± 351 ms, p = 0.291) and T2 relaxation times (356 ± 236 ms vs. 129 ± 68 ms, p = 0.155) not reaching statistical significance. Conclusions: Parametric CMR showed elevated native T1 and T2 relaxation times and ECV values in cardiac myxomas compared to normal myocardium, reflecting an increased interstitial space and fluid content. This might help in the differentiation of cardiac myxomas from other tumor entities.

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MR first pass perfusion of benign and malignant cardiac tumours—significant differences and diagnostic accuracy

Abstract: With first pass perfusion, malignant cardiac masses can be identified with higher sensitivity and specificity compared with morphological image assessment alone.

Cited by 15 publications

References 46 publications

Percutaneous ultrasound-guided core needle biopsy for the diagnosis of cardiac tumors: Optimizing the treatment strategy for patients with intermural and pericardial cardiac tumors

Percutaneous ultrasound-guided core needle biopsy for the diagnosis of cardiac tumors: Optimizing the treatment strategy for patients with intermural and pericardial cardiac tumors

Multiparametric mapping by cardiovascular magnetic resonance imaging in cardiac tumors

Cardiac Myxomas Show Elevated Native T1, T2 Relaxation Time and ECV on Parametric CMR

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