Usefulness of magnetic resonance imaging of cardiac and paracardiac masses

Hoffmann, Udo; Globits, Sebastian; Schima, Wolfgang; Loewe, Christian; Puig, Stefan; Oberhuber, Georg; Frank, Herbert

doi:10.1016/s0002-9149(03)00911-1

Cited by 181 publications

(93 citation statements)

References 16 publications

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“…This literature is extensive; however, the vast majority of the data, even those from recent publications, 33 were acquired by early spin-echo techniques that have several limitations. They are slow (several minutes per image) and prone to motion artifacts due to free breathing during image acquisition, and they provide limited T 1 weighting.…”

Section: Morphology and Functionmentioning

confidence: 99%

“…Differentiation between benign and malignant masses from image intensity features, however, was usually poor. 33 These older spin-echo techniques are no longer used in clinical practice. Instead, at present, a typical protocol for the evaluation of a cardiac mass would consist of the following: (1) 1 or more stacks of single-shot imaging that combines rapid (0.25 seconds/slice) image acquisition with comprehensive an- (4) postcontrast delayed-enhancement imaging, which accentuates differences in contrast uptake between the mass and normal myocardium and between different regions of the mass ( Figure 7d).…”

Section: Morphology and Functionmentioning

confidence: 99%

See 1 more Smart Citation

Frontiers in Cardiovascular Magnetic Resonance

Fuster

Kim

2005

Circulation

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Section: Morphology and Functionmentioning

confidence: 99%

Section: Morphology and Functionmentioning

confidence: 99%

Frontiers in Cardiovascular Magnetic Resonance

Fuster

Kim

2005

Circulation

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“…However, one has to consider that first, 18 F-FDG PET and cardiac MR imaging alone have already been reported to yield high sensitivity and specificity (9,10), and second, the sample size in the present study was relatively small. In fact, there were just 2 cases (both with an SUV max of 5.2) that could not be differentiated using 18 F-FDG PET alone.…”

Section: Discussionmentioning

confidence: 87%

“…Cardiac MR imaging has been shown to be particularly helpful in the diagnostic workup of cardiac tumors (4,9). More recently, 18 F-FDG PET/CT has been shown to provide incremental diagnostic information in the determination of malignancy and staging of cardiac tumors (10).…”

mentioning

confidence: 99%

Integrated ¹⁸F-FDG PET/MR Imaging in the Assessment of Cardiac Masses: A Pilot Study

et al. 2014

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The objective of the present study was to evaluate whether integrated 18 F-FDG PET/MR imaging could improve the diagnostic workup in patients with cardiac masses. Methods: Twenty patients were prospectively assessed using integrated cardiac 18 F-FDG PET/MR imaging: 16 patients with cardiac masses of unknown identity and 4 patients with cardiac sarcoma after surgical therapy. All scans were obtained on an integrated 3-T PET/MR device. The MR protocol consisted of half Fourier acquisition single-shot turbo spin-echo sequence, cine, and T2-weighted images as well as T1-weighted images before and after injection of gadobutrol. PET data were acquired simultaneously with the MR scan after injection of 199 ± 58 MBq of 18 F-FDG. Patients were prepared with a high-fat, lowcarbohydrate diet in a period of 24 h before the examination, and 50 IU/kg of unfractionated heparin were administered intravenously 15 min before 18 F-FDG injection. Results: Cardiac masses were diagnosed as follows: metastases, 3; direct tumor infiltration via pulmonary vein, 1; local relapse of primary sarcoma after surgery, 2; Burkitt lymphoma, 1; scar/patch tissue after surgery of primary sarcoma, 2; myxoma, 4; fibroelastoma, 1; caseous calcification of mitral annulus, 3; and thrombus, 3. The maximum standardized uptake value (SUV max ) in malignant lesions was significantly higher than in nonmalignant cases (13.2 ± 6.2 vs. 2.3 ± 1.2, P 5 0.0004). When a threshold of 5.2 or greater was used, SUV max was found to yield 100% sensitivity and 92% specificity for the differentiation between malignant and nonmalignant cases. T2-weighted hyperintensity and contrast enhancement both yielded 100% sensitivity but a weak specificity of 54% and 46%, respectively. Morphologic tumor features as assessed by cine MR imaging yielded 86% sensitivity and 92% specificity. Consent interpretation using all available MR features yielded 100% sensitivity and 92% specificity. A Boolean 'AND' combination of an SUV max of 5.2 or greater with consent MR image interpretation improved sensitivity and specificity to 100%. Conclusion: In selected patients, 18 F-FDG PET/MR imaging can improve the noninvasive diagnosis and follow-up of cardiac masses.

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“…3D contrast angiography is an excellent tool for the assessment of aortic aneurysms, and has high sensitivities and specificities for the diagnosis of aortic dissection (139). The combined use of different sequences providing T1 and T2 contrast, with and without fat suppression, perfusion imaging and assessment of contrast uptake, allow for noninvasive tissue characterization of cardiac and paracardiac masses (140). Additionally, high-resolution images can be obtained to exactly assess the spatial extent of a tumour.…”

Section: Further Clinical Applications Of Cmrmentioning

confidence: 99%