| 1. Ni JR, Hu Y, Shao LP, Song B, Li YM, Lei JQ. The diagnostic performance of magnetic resonance imaging for differentiating the nature of cardiac masses: A systematic review protocol. Medicine (Baltimore). 2020 Jan;99(2):e18717. |
Meta-analysis |
N/A |
To perform a systematic review on this issue and provide useful information for clinical diagnosis and treatment. |
No results stated in abstract. |
Not Assessed |
| 2. Petris AO, Alexandrescu DM, Costache II. Cardiac tumors. Rev Med Chir Soc Med Nat Iasi. 2014;118(2):289-92. |
Review/Other-Dx |
N/A |
Paraclinical methods (especially imaging evaluation) are always necessary for the complete diagnosis. |
No results stated in abstract. |
4 |
| 3. Martineau P, Dilsizian V, Pelletier-Galarneau M. Incremental Value of FDG-PET in the Evaluation of Cardiac Masses. Curr Cardiol Rep. 2021 Jun 03;23(7):78. |
Review/Other-Dx |
N/A |
To review the various roles and evidence underlying the use of fluorodeoxyglucose (FDG) PET/CT and PET/MR for the assessment of cardiac masses. |
The role of FDG-PET for the evaluation of cardiac masses continues to evolve. Studies have shown that FDG-PET is particularly well-suited for differentiating malignant from benign cardiac lesions based on their metabolic activity. Furthermore, FDG-PET is uniquely positioned to investigate patients with cardiac mass as most malignant cardiac lesions are metastasis. Finally, FDG-PET enables staging of patients with primary malignant cardiac tumor, identification of potential biopsy site, and planning of radiotherapy. FDG-PET is a complementary tool for the evaluation of patients with cardiac mass and can help differentiate benign from malignant lesions, as well as provide whole-body staging. |
4 |
| 4. Ejim EC, Anisiuba BC, Ike SO, et al. Intra-cardiac masses in adults: a review of echocardiogram records at two echocardiographic laboratories in Enugu, South-East Nigeria. Niger J Clin Pract. 2013;16(4):468-72. |
Observational-Dx |
2,814 |
The study aimed to identify the common types of cardiac masses and their commonest locations in the heart. |
There were 2,814 echo examinations in adults over this period, comprising 1,661 males (59.1%) and 1,153 females (40.9%). Intra-cardiac masses were found in 20 of these patients representing 0.7% of the study population. Thrombi were the commonest masses noted in our study, and there were more masses in the atria than in the ventricles. The left heart chambers also had more masses than the right heart chambers. There was no sex difference in the frequency of cardiac masses. |
3 |
| 5. Prabhu N, DeCara JM. Imaging Cardiac Masses in Patients with Cancer. Isr Med Assoc J. 2022 Mar;24(3):186-190. |
Review/Other-Dx |
N/A |
In patients with cancer, cardiac and chest imaging is a common occurrence. |
No results stated in abstract. |
4 |
| 6. Terry NLJ, Manapragada P, Aziz MU, Singh SP. Cardiac mass evaluation with cardiac computed tomography: A review. J Med Imaging Radiat Sci. 2021 Nov;52(3S):S1939-8654(21)00231-9. |
Review/Other-Dx |
N/A |
The role of computed tomography (CT) in the evaluation of various cardiac masses. |
No results stated in abstract. |
4 |
| 7. Maleszewski JJ, Basso C, Bois MC, et al. The 2021 WHO Classification of Tumors of the Heart. J Thorac Oncol. 2022 Apr;17(4):S1556-0864(21)03318-9. |
Review/Other-Dx |
N/A |
Updated classification of cardiac tumors. |
No results stated in abstract. |
4 |
| 8. Bussani R, Castrichini M, Restivo L, et al. Cardiac Tumors: Diagnosis, Prognosis, and Treatment. Curr Cardiol Rep. 2020 Oct 10;22(12):169. |
Review/Other-Dx |
N/A |
To provide an overview of cardiac tumors using a cardiac chamber prevalence approach and providing epidemiology, imaging, histopathology, diagnostic workup, treatment, and prognoses of cardiac tumors. |
Cardiac tumors are rare but remain an important component of cardio-oncology practice. Over the past decade, the advances in imaging techniques have enabled a noninvasive diagnosis in many cases. Indeed, imaging modalities such as cardiac magnetic resonance, computed tomography, and positron emission tomography are important tools for diagnosing and characterizing the lesions. Although an epidemiological and multimodality imaging approach is useful, the definite diagnosis requires histologic examination in challenging scenarios, and histopathological characterization remains the diagnostic gold standard. A comprehensive clinical and multimodality imaging evaluation of cardiac tumors is fundamental to obtain a proper differential diagnosis, but histopathology is necessary to reach the final diagnosis and subsequent clinical management. |
4 |
| 9. Tyebally S, Chen D, Bhattacharyya S, et al. Cardiac Tumors: JACC CardioOncology State-of-the-Art Review. JACC CardioOncol. 2020 Jun;2(2):293-311. |
Review/Other-Dx |
N/A |
A comprehensive review of the epidemiology, clinical presentation, imaging, diagnosis, management, and outcomes of cardiac masses. |
No results stated in abstract. |
4 |
| 10. Lorca MC, Chen I, Jew G, et al. Radiologic-Pathologic Correlation of Cardiac Tumors: Updated 2021 WHO Tumor Classification. Radiographics. 2024 Jun;44(6):e230126. |
Review/Other-Dx |
N/A |
Imaging individualized to a particular tumor type and location is crucial for treatment planning. |
No results stated in abstract. |
4 |
| 11. Oliveira GH, Al-Kindi SG, Hoimes C, Park SJ. Characteristics and Survival of Malignant Cardiac Tumors: A 40-Year Analysis of >500 Patients. Circulation. 2015 Dec 22;132(25):2395-402. |
Observational-Dx |
551 |
To investigate the incidence, histopathology, demographics, and survival associated with primary malignant cardiac tumors (PMCTs). |
The incidence of PMCT diagnosis is 34 cases per 100 million persons and has increased over time (25.1 in 1973-1989, 30.2 in 1990-1999, and 46.6 in 2000-2011). Most patients are female (54.1%) and white (78.6%) with median age at diagnosis of 50 years. The most common PMCTs are sarcomas (n=357, 64.8%), followed by lymphomas (n=150, 27%) and mesotheliomas (n=44, 8%). Most patients are diagnosed with tissue sample (96.8%). Although use of chemotherapy is not documented in SEER, 19% of patients received radiation and 44% had surgery. After a median follow-up of 80 months, 413 patients had died. The 1-, 3-, and 5-year survival rates were 46%, 22%, and 17% and have improved over the eras, with 1-, 3-, and 5-year survival rates of 32%, 17%, and 14% for 1973 to 1989 and 50%, 24%, and 19% for 2000 to 2011 (P=0.009). Cardiac sarcomas and mesotheliomas are the most lethal PMCTs, with 1-, 3-, 5-year survival rates of 47%, 16%, and 11% and of 51%, 26%, and 23% compared with 59%, 41%, and 34% for lymphomas, respectively (log rank test P<0.001). Patients with cardiac lymphomas and sarcomas are younger and have worse survival than patients with extracardiac disease of similar histopathology (P<0.001). |
4 |
| 12. Roberts WC. Primary and secondary neoplasms of the heart. Am J Cardiol. 1997 Sep 01;80(5):671-82. |
Review/Other-Dx |
N/A |
Primary and secondary neoplasms of the heart. |
No abstract available. |
4 |
| 13. Kikuchi Y, Oyama-Manabe N, Manabe O, et al. Imaging characteristics of cardiac dominant diffuse large B-cell lymphoma demonstrated with MDCT and PET/CT. Eur J Nucl Med Mol Imaging. 2013 Sep;40(9):1337-44. |
Review/Other-Dx |
17 patients |
To investigate the specific imaging findings of multidetector row CT (MDCT) and PET/CT with(18)F-FDG in cardiac dominant diffuse large B-cell lymphoma (DLBCL) in comparison with other cardiac tumours. |
Four of the five DLBCL patients had primarily right-sided cardiac lesions, which was seen significantly more frequently in DLBCL than in other cardiac tumours (p = 0.028). All cardiac DLBCL lesions were located around the atrioventricular groove and encased the coronary arteries. ECG-gated cardiac MDCT showed that there was no apparent stenosis of the coronary arteries. Large amounts of pericardial effusion were seen in all DLBCL patients. PET/CT revealed significantly higher FDG uptake in DLBCL than in other cardiac malignant tumours, with no overlap (p = 0.0007). |
4 |
| 14. Kim K, Ko WS, Kim SJ. Diagnostic test accuracies of F-18 FDG PET for characterisation of cardiac masses compared to conventional imaging techniques: systematic review and meta-analysis. Br J Radiol. 2022 Jul 01;95(1135):20210263. |
Meta-analysis |
6 studies
212 patients |
Compare the diagnostic performance of F-18 fludeoxyglucose positron emission tomography (18F-FDG PET) and conventional imaging, including MRI, echocardiography, and CT, in characterising cardiac masses. |
Of six included studies (n = 212 patients), 18F-FDG PET demonstrated a pooled sensitivity of 0.89 (95% confidence interval [CI] 0.81–0.94) and a pooled specificity of 0.89 (95% CI 0.80–0.94). LR syntheses yielded an overall LR+ of 7.9 (95% CI 4.3–14.6) and LR- of 0.12 (95% CI 0.07–0.22). The calculated pooled diagnostic odds ratio (DOR) was 64 (95% CI 23–181). For conventional imaging, the pooled sensitivity was 0.70 (95% CI 0.57–0.81) and the pooled specificity was 0.96 (95% CI 0.88–0.98). LR syntheses yielded an overall LR+ of 16.1 (95% CI 5.8–44.5) and LR- of 0.31 (95% CI 0.21–0.46). The evaluated pooled DOR was 52 (95% CI 17–155). |
Good |
| 15. Maybrook RJ, Afzal MR, Parashar S, et al. Intrinsic and Extrinsic Cardiac Pseudotumors: Echocardiographic Evaluation and Review of the Literature. Echocardiography. 2016 Jan;33(1):117-32. |
Review/Other-Dx |
N/A |
To describe common cardiac pseudotumors and to classify them based on their origin. |
No results stated in abstract. |
4 |
| 16. American College of Radiology. ACR–NASCI–SIR–SPR Practice Parameter for the Performance and Interpretation of Body Computed Tomography Angiography (CTA). Available at: https://gravitas.acr.org/PPTS/GetDocumentView?docId=164+&releaseId=2. |
Review/Other-Dx |
N/A |
Guidance document to promote the safe and effective use of diagnostic and therapeutic radiology by describing specific training, skills and techniques. |
No abstract available. |
4 |
| 17. Malik SB, Hsu JY, et al. ACR Appropriateness Criteria® Infective Endocarditis. J Am Coll Radiol. 2021 May;18(5S):S1546-1440(21)00029-6. |
Review/Other-Dx |
N/A |
Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for infective endocarditis. |
No results stated in abstract. |
4 |
| 18. Shin W, Choe YH, Kim SM, Song IY, Kim SS. Detection of cardiac myxomas with non-contrast chest CT. Acta Radiol. 2014 Apr;55(3):273-8. |
Review/Other-Dx |
36 patients |
To evaluate the diagnostic capability of non-contrast CT covering heart in detecting cardiac myxomas. |
The average attenuation of cardiac myxoma (22.5 Hounsfield units [HU]; range, 8.9-32.9 HU) and adjacent unopacified blood (44.6 HU; range, 31.5-57 HU) were significantly different (P < 0.001). Twelve cardiac myxomas (31.6%) had internal calcification and all of them were detected by both of readers. Cardiac myxomas were measured smaller on non-contrast CT (mean, 3.5 cm; range, 1.1-9.7 cm) than on pathologic specimens (mean, 4.1 cm, 1.4-10.0 cm) (P < 0.001). Considering grade 3-5 on a five-grade scale as the detectability, the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of non-contrast CT in detecting cardiac myxomas were 88.8%/86.1%, 95.0%/100%, 96.9%/100%, 82.6%/80.0%, and 91.1%/91.1%, by reader 1 and reader 2, respectively and there was good inter-observer reliability (kappa value = 0.92, P = 0.157). |
4 |
| 19. Saric M, Armour AC, Arnaout MS, et al. Guidelines for the Use of Echocardiography in the Evaluation of a Cardiac Source of Embolism. J Am Soc Echocardiogr. 2016 Jan;29(1):S0894-7317(15)00728-2. |
Review/Other-Dx |
N/A |
Guidelines on the use of echocardiography for evaluation of cardiac sources of embolism. |
No results stated in abstract. |
4 |
| 20. Apfaltrer G, Lavra F, De Cecco CN, et al. Predictive Value of Cardiac CTA, Cardiac MRI, and Transthoracic Echocardiography for Cardioembolic Stroke Recurrence. AJR Am J Roentgenol. 2021 Aug;217(2):336-346. |
Review/Other-Dx |
151 patients |
To investigate sensitivity, specificity, and predictive value of cardiac CTA (CCTA), cardiac MRI (CMRI), and TTE for recurrence in patients with suspected cardioembolic stroke. |
Twelve and 14 recurrent strokes occurred in the CCTA and CMRI groups, respectively. Sensitivity, specificity, PPV, and NPV were 33.3%, 93.7%, 50.0%, and 88.2% for CCTA; 14.3%, 80.3%, 14.3%, and 80.3% for CMRI; 14.3%, 83.6%, 16.7%, and 80.9% for TTE in the CMRI group; and 8.3%, 93.7%, 20.0%, and 84.5% for TTE in the CCTA group. Accuracy was not different (p > .05) between CCTA (AUC = 0.63; 95% CI, 0.49-0.77), CMRI (0.53; 95% CI, 0.42-0.63), TTE in the CMRI group (0.51; 95% CI, 0.40-0.61), and TTE in the CCTA group (0.51; 95% CI, 0.42-0.59). In the CCTA group, atrial and ventricular thrombus were detected by CCTA in three patients and TTE in one patient; in the CMRI group, thrombus was detected by CMRI in one patient and TTE in two patients. |
4 |
| 21. Rinkel LA, Guglielmi V, Beemsterboer CFP, et al. Diagnostic Yield of ECG-Gated Cardiac CT in theAcute Phase of Ischemic Stroke vsTransthoracic Echocardiography. Neurology. 2022 Oct 04;99(14):e1456-e1464. |
Observational-Dx |
452 patients |
To determine whether cardiac CT, acquired during the initial stroke imaging protocol, has a higher yield for detecting high-risk cardioaortic sources of embolism than transthoracic echocardiography (TTE). |
Between May 2018 and November 2020, 774 patients with a suspected ischemic stroke underwent hyperacute cardiac CT. We excluded 228 patients with a diagnosis other than ischemic stroke and 94 because they did not provide informed consent. Therefore, 452 patients (59.3% male, median age 72) were included. The median additional scan time of cardiac CT was 6 (interquartile range 5-7) minutes with poor scan quality in only 3%. In total, 350 of the 452 patients (77.4%) underwent TTE, 99 of whom were performed in an outpatient setting. Reasons for not undergoing TTE were death (33, 7.3%) and TTE being too burdensome to perform in the outpatient setting (69, 15.3%). A high-risk cardioaortic source of embolism was detected in 40 of the 350 patients (11.4%) on CT, compared with 17 of the 350 (4.9%) on TTE (odds ratio 5.60, 95% CI 2.28-16.33). Cardiac thrombus was the most frequent finding (7.1% vs 0.6%). The diagnostic yield of cardiac CT in the full study population was 55 of the 452 (12.2%). Among the 175 patients with cryptogenic stroke after the routine workup, cardiac CT identified a cause of the stroke in 11 (6.3%). |
1 |
| 22. Kauw F, Velthuis BK, Takx RAP, et al. Detection of Cardioembolic Sources With Nongated Cardiac Computed Tomography Angiography in Acute Stroke: Results From the ENCLOSE Study. Stroke. 2023 Mar;54(3):821-830. |
Observational-Dx |
370 patients |
Identifying cardioembolic sources in patients with acute ischemic stroke is important for the choice of secondary prevention strategies. |
Forty four (12%) of 370 included patients had a cardiac thrombus on admission CTA: 35 (9%) in the left atrial appendage and 14 (4%) in the left ventricle. Patients with cardiac thrombus had more severe strokes (median National Institutes of Health Stroke Scale score, 10 versus 4; P=0.006), had higher clot burden (median clot burden score, 9 versus 10; P=0.004), and underwent endovascular treatment more often (43% versus 20%; P<0.001) than patients without cardiac thrombus. Left atrial appendage thrombus was present in 28% and 6% of the patients with and without atrial fibrillation, respectively (P<0.001). The diagnostic certainty for left atrial appendage thrombus was higher for spectral iodine maps compared with the conventional CTA (P<0.001). The presence of cardiac thrombus on CTA increased the likelihood of a cardioembolic source according to the expert panel (P<0.001). |
2 |
| 23. Li W, Liu M, Yu F, et al. Detection of left atrial appendage thrombus by dual-energy computed tomography-derived imaging biomarkers in patients with atrial fibrillation. Front Cardiovasc Med. 2022;9():809688. |
Observational-Dx |
389 patients with atrial fibrillation |
to assess the diagnostic performances of dual-energy computed tomography (CT)-derived iodine concentration and effective atomic number (Z eff ) in early-phase cardiac CT in detecting left atrial appendage (LAA) thrombus and differentiating thrombus from spontaneous echo contrast (SEC) in patients with atrial fibrillation using transesophageal echocardiography (TEE) as the reference standard. |
A total of 389 patients with atrial fibrillation were prospectively recruited. All patients underwent a single-phase cardiac dual-energy CT scan using a third-generation dual-source CT. The iodine concentration, Z eff , and conventional Hounsfield units (HU) in the LAA were measured and normalized to the ascending aorta (AA) of the same slice to calculate the LAA/AA ratio. Of the 389 patients, TEE showed thrombus in 15 (3.9%), SEC in 33 (8.5%), and no abnormality in 341 (87.7%) patients. Using TEE findings as the reference standard, the respective sensitivity, specificity, positive predictive value, and negative predictive value of the LAA/AA HU ratio for detecting LAA thrombus were 100.0, 96.8, 55.6, and 100.0%; those of the LAA/AA iodine concentration ratio were 100.0, 99.2, 83.3, and 100.0%; and those of the LAA/AA Z eff ratio were 100.0, 98.9, 79.0, and 100.0%. The areas under the receiver operator characteristic curve (AUC) of the LAA/AA iodine concentration ratio (0.978; 95% CI 0.945-1.000) and Z eff ratio (0.962; 95% CI 0.913-1.000) were significantly larger than that of the LAA/AA HU ratio (0.828; 95% CI 0.714-0.942) in differentiating the thrombus from the SEC (both P < 0.05). Although the AUC of the LAA/AA iodine concentration ratio was larger than that of the LAA/AA Z eff ratio, no significant difference was found between them (P = 0.259). |
1 |
| 24. Hur J, Kim YJ, Lee HJ, et al. Cardioembolic stroke: dual-energy cardiac CT for differentiation of left atrial appendage thrombus and circulatory stasis. Radiology. 2012 Jun;263(3):688-95. |
Observational-Dx |
32 patients with stroke who had atrial fibrillation; 31 patients in control group |
To assess the diagnostic performance of dual-energy cardiac computed tomography (CT) in the detection of left atrial appendage (LAA) thrombi and differentiation between thrombus and circulatory stasis in patients with stroke, by using transesophageal echocardiography (TEE) as the reference standard. |
Among the 63 patients, a total of 13 thrombi and 19 instances of SEC were detected at TEE. Using TEE as the reference standard, the overall sensitivity, specificity, positive predictive value, and negative predictive value of dual-energy cardiac CT in the detection of thrombi and SEC in the LAA were 97% (95% confidence interval [CI]: 82%, 100%), 100% (95% CI: 86%, 100%), 100%, and 97%, respectively. At CT, the mean iodine concentration was 1.23 mg/mL ± 0.34 (standard deviation) for thrombus and 3.61 mg/mL ± 1.01 for SEC (P = .001). |
1 |
| 25. Feuchtner GM, Stolzmann P, Dichtl W, et al. Multislice computed tomography in infective endocarditis: comparison with transesophageal echocardiography and intraoperative findings. J Am Coll Cardiol. 2009 Feb 03;53(5):436-44. |
Observational-Dx |
37 consecutive patients |
To determine the value of multislice CT for the assessment of valvular abnormalities compared with TEE and intraoperative findings in patients with infective endocarditis. |
CT had sensitivity 97%, specificity 88%, PPV 97%, and NPV 88% on a per-patient basis (n = 37; excellent intermodality agreement kappa = 0.84). CT correctly identified 26/27 (96%) patients with valvular vegetations and 9/9 (100%) patients with abscesses/pseudoaneurysms compared with the intraoperative specimen. On a per-valve-based analysis, diagnostic accuracy for the detection of vegetations and abscesses/pseudoaneurysms compared with surgery was: sensitivity 96%, specificity 97%, PPV 96%, NPV 97%, and sensitivity 100%, specificity 100%, PPV 100%, NPV 100%, respectively. Multislice CT shows good results in detecting valvular abnormalities in infective endocarditis and could be applied in preoperative planning and exclusion of coronary artery disease before surgery. |
2 |
| 26. Wang TKM, Bin Saeedan M, Chan N, et al. Complementary Diagnostic and Prognostic Contributions of Cardiac Computed Tomography for Infective Endocarditis Surgery. Circ Cardiovasc Imaging. 2020 Sep;13(9):e011126. |
Review/Other-Dx |
833 patients |
To evaluate the associations between cardiac CT and transesophageal echocardiography (TEE) findings and adverse outcomes after IE surgery. |
CT and TEE were positive for IE in 123 (75.0%) and 124 (75.6%) of patients, respectively. Thirty-day mortality occurred in 3 (1.9%) patients and composite mortality or morbidities in 72 (46.5%). Pseudoaneurysm or abscess detected on TEE was the only imaging biomarker to show independent association with composite mortality or morbidities in-hospital, with odds ratio (95% CI) of 3.66 (1.76-7.59), P=0.001. There were 17 late deaths, and both pseudoaneurysm or abscess detected on CT and fistula detected on CT were the only independent predictors of total mortality during follow-up, with hazards ratios (95% CI) of 3.82 (1.25-11.7), P<0.001 and 9.84 (1.89-51.0), P=0.007, respectively. |
4 |
| 27. Romero J, Husain SA, Kelesidis I, Sanz J, Medina HM, Garcia MJ. Detection of left atrial appendage thrombus by cardiac computed tomography in patients with atrial fibrillation: a meta-analysis. Circ Cardiovasc Imaging. 2013 Mar 01;6(2):185-94. |
Meta-analysis |
19 studies with 2955 patients |
To evaluate the diagnostic accuracy of cardiac computed tomography assessing left atrial/LA appendage (LA/LAA) thrombi in comparison with transesophageal echocardiogram (TEE) . |
Nineteen studies with 2955 patients (men, 71%; mean age, 61±4 years) fulfilled the inclusion criteria. Most studies (85%, 16 studies) used 64-slide multidetector computed tomography and 15 studies (79%) were electrocardiographic-gated. The incidence of LA/LAA thrombi was 8.9% (SD, ±7). The mean sensitivity and specificity were 96% and 92%, whereas the positive predictive value and negative predictive value were 41% and 99%, respectively. The diagnostic accuracy was 94%. In a subanalysis of studies in which delayed imaging was performed, the diagnostic accuracy significantly improved to a mean weighted sensitivity and specificity of 100% and 99%, respectively, whereas the positive predictive value and negative predictive value increased to 92% and 100%, respectively. The accuracy for this technique was 99%. |
Good |
| 28. de la Fuente J, Wang Y, Tan N, Kandlakunta H, Tse CS, Click RL. Cardiac Masses (from a 15-Year Experience With 389 Surgical Cases). Am J Cardiol. 2022 Dec 15;185():S0002-9149(22)01004-9. |
Observational-Dx |
389 surgical patient cases |
To provide a comprehensive analysis of all noninfectious cardiac masses that were surgically resected at our institution. |
For the detection of cardiac masses, transthoracic echocardiography was the most frequently used but least sensitive of the imaging methods analyzed. Transesophageal echocardiography (TEE) was the most sensitive imaging method. Fluorodeoxyglucose Positron Emission Tomography had similar sensitivity to TEE but was the least frequently used imaging method. Computed tomography and magnetic resonance imaging performed well in detecting most masses; PFEs, for which TEE was the most sensitive, was the exception. |
4 |
| 29. Srichai MB, Junor C, Rodriguez LL, et al. Clinical, imaging, and pathological characteristics of left ventricular thrombus: a comparison of contrast-enhanced magnetic resonance imaging, transthoracic echocardiography, and transesophageal echocardiography with surgical or pathological validation. Am Heart J. 2006 Jul;152(1):75-84. |
Observational-Dx |
61 patients with ischemic heart disease |
To evaluated the clinical, imaging, and pathology characteristics of confirmed LV thrombus and compared the diagnostic value of contrast-enhanced magnetic resonance imaging (MRI) with transthoracic (TTE) and transesophageal echocardiography (TEE) for the diagnosis of LV thrombi. |
Left ventricular thrombus was present in 106 (29%) of 361 patients in this study. Patients with thrombus had a higher incidence of recent embolic events (6.1% vs 0.8%, P < .005). In 160 patients with all 3 imaging modalities performed within 30 days of surgical or pathological confirmation, contrast-enhanced MRI showed the highest sensitivity and specificity (88% +/- 9% and 99% +/- 2%, respectively) compared with TTE (23% +/- 12% and 96% +/- 3.6%, respectively) and TEE (40% +/- 14% and 96% +/- 3.6%, respectively) for thrombus detection. |
3 |
| 30. Pazos-López P, Pozo E, Siqueira ME, et al. Value of CMR for the differential diagnosis of cardiac masses. JACC Cardiovasc Imaging. 2014 Sep;7(9):S1936-878X(14)00486-0. |
Observational-Dx |
116 patients |
To evaluate the diagnostic value of CMR features for the differential diagnosis of cardiac masses. |
There were 84 thrombi, 17 benign tumors, and 25 malignant tumors in 116 patients. Morphologically, thrombi were smaller (median area 1.6 vs. 8.5 cm(2); p < 0.0001), more homogeneous (99% vs. 46%; p < 0.0001), and less mobile (13% vs. 33%; p = 0.007) than tumors. Hyperintensity compared with normal myocardium on T2w-TSE, FPP, and LGE were more common in tumors than in thrombi (85% vs. 42%, 70% vs. 4%, and 71% vs. 5%, respectively; all p < 0.0001). A pattern of hyperintensity/isointensity (compared with normal myocardium) with short TI and hypointensity with long TI was very frequent in thrombi (94%), rare in tumors (2%), and had the highest accuracy (95%) for the differentiation of both entities. Regarding the characterization of neoplastic masses, malignant tumors were larger (median area 11.9 vs. 6.3 cm(2); p = 0.006) and more frequently exhibited FPP (84% vs. 47%; p = 0.03) and LGE (92% vs. 41%; p = 0.001). The ability of CMR features to distinguish benign from malignant neoplasms was moderate, with LGE showing the highest accuracy (79%). |
3 |
| 31. Weinsaft JW, Kim J, Medicherla CB, et al. Echocardiographic Algorithm for Post-Myocardial Infarction LV Thrombus: A Gatekeeper for Thrombus Evaluation by Delayed Enhancement CMR. JACC Cardiovasc Imaging. 2016 May;9(5):S1936-878X(15)00681-6. |
Experimental-Dx |
201 patients |
To determine the prevalence of post-myocardial infarction (MI) left ventricular (LV) thrombus in the current era and to develop an effective algorithm (predicated on echocardiography [echo]) to discern patients warranting further testing for thrombus via delayed enhancement (DE) cardiac magnetic resonance (CMR). |
A total of 201 patients were studied; 8% had thrombus according to DE-CMR. All thrombi were apically located; 94% of thrombi occurred in the context of a left anterior descending (LAD) infarct-related artery. Although patients with thrombus had more prolonged chest pain and larger MI (p = 0.01), only 18% had aneurysm on echo (cine-CMR 24%). Noncontrast (35%) and contrast (64%) echo yielded limited sensitivity for thrombus on DE-CMR. Thrombus was associated with stepwise increments in basal ? apical contractile dysfunction on echo and quantitative cine-CMR; the echo-measured apical wall motion score was higher among patients with thrombus (p < 0.001) and paralleled cine-CMR decrements in apical ejection fraction and peak ejection rates (both p < 0.005). Thrombus-associated decrements in apical contractile dysfunction were significant even among patients with LAD infarction (p < 0.05). The echo-based apical wall motion score improved overall performance (area under the curve 0.89 ± 0.44) for thrombus compared with ejection fraction (area under the curve 0.80 ± 0.61; p = 0.01). Apical wall motion partitions would have enabled all patients with LV thrombus to be appropriately referred for DE-CMR testing (100% sensitivity and negative predictive value), while avoiding further testing in more than one-half (56% to 63%) of patients. |
1 |
| 32. Weinsaft JW, Kim RJ, Ross M, et al. Contrast-enhanced anatomic imaging as compared to contrast-enhanced tissue characterization for detection of left ventricular thrombus. JACC Cardiovasc Imaging. 2009 Aug;2(8):969-79. |
Observational-Dx |
121 patients |
To compare contrast-enhanced anatomic imaging and contrast-enhanced tissue characterization (delayed-enhancement cardiac magnetic resonance [DE-CMR]) for left ventricular (LV) thrombus detection. |
Twenty-four patients had thrombus by DE-CMR. Patients with thrombus had larger infarcts (by DE-CMR), more aneurysms, and lower LV ejection fraction (by CMR and echo) than those without thrombus. Contrast echo nearly doubled sensitivity (61% vs. 33%, p < 0.05) and yielded improved accuracy (92% vs. 82%, p < 0.01) versus noncontrast echo. Patients who derived incremental diagnostic utility from DE-CMR had lower LV ejection fraction versus those in whom noncontrast echo alone accurately assessed thrombus (35 +/- 9% vs. 42 +/- 14%, p < 0.01), with a similar trend for patients who derived incremental benefit from contrast echo (p = 0.08). Contrast echo and cine-CMR closely agreed on the diagnosis of thrombus (kappa = 0.79, p < 0.001). Thrombus prevalence was lower by contrast echo than DE-CMR (p < 0.05). Thrombus detected by DE-CMR but not by contrast echo was more likely to be mural in shape or, when apical, small in volume (p < 0.05). |
1 |
| 33. Mollet NR, Dymarkowski S, Volders W, et al. Visualization of ventricular thrombi with contrast-enhanced magnetic resonance imaging in patients with ischemic heart disease. Circulation. 2002 Dec 03;106(23):2873-6. |
Review/Other-Dx |
57 patients with acute myocardial infarction, chronic myocardial infarction, or ischemic cardiomyopathy |
To evaluate the role of CE-MRI in detecting ventricular thrombi in patients with ischemic heart disease. |
CE-MRI depicted 12 mural thrombi (3.1+/-2.9 cm3), located in left ventricular (LV) apex or adherent to anteroseptum, presenting as black, well-defined structures surrounded by bright contrast-enhanced blood. Thrombus formation on CE-MRI was related to larger end-diastolic volumes; lower ejection fractions; the region of delayed enhancement and lowest wall motion score, especially in left anterior descending coronary artery territory; and LV aneurysm formation. On CINE-MRI, thrombi were found in 6 patients. Nonvisualized thrombi were usually small (mean size 1.2+/-0.7 cm3). TTE depicted thrombi in 5. Nonvisualized lesions were most frequently located in LV apex and had a larger size than nonvisualized lesions on CINE-MRI (3.0+/-3.2 cm3). In 3 patients with suspected apical thrombus on TTE, MRI was normal. |
4 |
| 34. Weinsaft JW, Kim HW, Shah DJ, et al. Detection of left ventricular thrombus by delayed-enhancement cardiovascular magnetic resonance prevalence and markers in patients with systolic dysfunction. J Am Coll Cardiol. 2008 Jul 08;52(2):148-57. |
Observational-Dx |
784 consecutive patients |
To assess the prevalence and markers of left ventricular (LV) thrombus among patients with systolic dysfunction. |
Among this at-risk population (age 60 +/- 14 years; LVEF 32 +/- 11%), DE-CMR detected thrombus in 7% (55 patients) and cine-CMR in 4.7% (37 patients, p < 0.005). Follow-up was consistent with DE-CMR as a better reference standard than cine-CMR, including 100% detection among 5 patients with thrombus verified by pathology (cine-CMR, 40% detection), and logistic regression analysis testing the contributions of DE-CMR and cine-CMR simultaneously, which showed that only the presence of thrombus by DE-CMR was associated with follow-up end points (p < 0.005). Cine-CMR generally missed small intracavitary and small or large mural thrombus. In addition to traditional indices such as low LVEF and ischemic cardiomyopathy, multivariable analysis showed that increased myocardial scarring, an additional parameter available from DE-CMR, was an independent risk factor for thrombus. |
2 |
| 35. Plodkowski AJ, Chan A, Gupta D, et al. Diagnostic utility and clinical implication of late gadolinium enhancement cardiac magnetic resonance for detection of catheter associated right atrial thrombus. Clin Imaging. 2020 Jun;62():S0899-7071(20)30034-6. |
Observational-Dx |
130 cancer patients with central venous catheters |
To use delayed enhancement cardiac magnetic resonance (DE-CMR) as a reference standard to evaluate the prevalence and predictors of right atrial (RA) thrombus. |
31/130 (24%) patients had RA thrombus on DE-CMR. Echocardiography (attained in 64% of the study population) demonstrated moderate sensitivity and specificity (75%, 90% respectively) in relation to DE-CMR; cine-CMR performance was higher (sensitivity 90%, specificity 98%). Patients with and without RA thrombus had similar right-sided structure/function and cancer diagnosis. Catheter depth approached significance in patients with RA thrombus (p = 0.05). 13% of patients with RA thrombus had concomitant pulmonary embolism within 60 days of CMR vs. 2% of patients without RA thrombus (p = 0.03). Embolic events were independent of RA thrombus size (p = 0.66). |
2 |
| 36. Roifman I, Connelly KA, Wright GA, Wijeysundera HC. Echocardiography vs. Cardiac Magnetic Resonance Imaging for the Diagnosis of Left Ventricular Thrombus: A Systematic Review. Can J Cardiol. 2015 Jun;31(6):S0828-282X(15)00036-7. |
Review/Other-Dx |
7 studies |
To conduct a systematic review to compare the accuracy of transthoracic echocardiography (TTE) with that of cardiac magnetic resonance (CMR) imaging for the detection of LV thrombi. |
Our results suggest that late gadolinium enhancement CMR imaging is the most accurate modality for the detection of LV thrombi (sensitivity 88%, specificity 99%), followed by cine-CMR imaging (sensitivity 58%-79%, specificity 99%, accuracy 95%, positive predictive value 93%-95%, negative predictive value 95%-96%), contrast TTE (sensitivity 23%-61%, specificity 96%-99%, accuracy 92%, positive predictive value 93%, negative predictive value 91%), and, finally, noncontrast TTE (sensitivity 24%-33%, specificity 94%-95%, accuracy 82%, positive predictive value 57%, negative predictive value 85%). Accuracy of TTE might be improved if a clear clinical indication is provided and with routine use of LV opacifying contrast agents. |
4 |
| 37. McMahon NE, Bangee M, Benedetto V, et al. Etiologic Workup in Cases of Cryptogenic Stroke: A Systematic Review of International Clinical Practice Guidelines. Stroke. 2020 May;51(5):1419-1427. |
Review/Other-Dx |
16 clinical practice guidelines and 7 consensus statements |
To systematically assess the extent to which there exists consensus, disagreement, and gaps in clinical practice recommendations on etiologic workup in acute ischemic stroke. |
We retrieved 16 clinical practice guidelines and 7 consensus statements addressing acute stroke management (n=12), atrial fibrillation (n=5), imaging (n=5), and secondary prevention (n=1). Five reports were of overall high quality. For all patients, guidelines recommended routine brain imaging, noninvasive vascular imaging, a 12-lead ECG, and routine blood tests/laboratory investigations. Additionally, ECG monitoring (>24 hours) was recommended for patients with suspected embolic stroke and echocardiography for patients with suspected cardiac source. Three reports recommended investigations for rarer causes of stroke. None of the reports provided guidance on the extent of investigation needed before classifying a stroke as cryptogenic. |
4 |
| 38. Mügge A, Daniel WG, Frank G, Lichtlen PR. Echocardiography in infective endocarditis: reassessment of prognostic implications of vegetation size determined by the transthoracic and the transesophageal approach. J Am Coll Cardiol. 1989 Sep;14(3):631-8. |
Review/Other-Dx |
105 patients |
In 105 patients with active infective endocarditis, disease-assoaciated complications defined as severe heart failure (New York Heart Association class IV), embolic events and in-hospital death were correlated to the vegetation size determined by both transthoracic and transesophageal echocardiography. |
The correlation of vegetation size with endocarditis-associated complications showed that patients with a vegetation diameter >10 mm had a significantly higher incidence of embolic events than did those with a vegetation diameter =10 mm (22 of 47 versus 11 of 58; p < 0.01). Particularly for patients with mitral valve endocarditis, a vegetation diameter >10 mm was highly sensitive in identifying patients at risk for embolic events. Vegetation size, however, was not significantly different in patients with and without severe heart failure or in patients surviving or dying during acute endocarditis. In addition, no significant correlation was found between vegetation size and location of endocarditis or type of infective organism. |
4 |
| 39. Weinsaft JW, Kim HW, Crowley AL, et al. LV thrombus detection by routine echocardiography: insights into performance characteristics using delayed enhancement CMR. JACC Cardiovasc Imaging. 2011 Jul;4(7):702-12. |
Observational-Dx |
243 patients |
This study sought to evaluate performance characteristics of routine echo for left ventricular thrombus (LVT). |
In this study, 243 patients had routine clinical echo and dedicated CMR within 1 week without intervening events. Follow-up supported DE-CMR as a reference standard, with >5-fold difference in endpoints between patients with versus without LVT by DE-CMR (p = 0.02). LVT prevalence was 10% by DE-CMR. Echo contrast was used in 4% of patients. Echo sensitivity and specificity were 33% and 91%, with positive and negative predictive values of 29% and 93%. Among patients with possible LVT as the clinical indication for echo, sensitivity and positive predictive value were markedly higher (60%, 75%). Regarding sensitivity, echo performance related to LVT morphology and mirrored cine-CMR, with protuberant thrombus typically missed when small (p = 0.02). There was also a strong trend to miss mural thrombus irrespective of size (p = 0.06). Concerning positive predictive value, echo performance related to image quality, with lower diagnostic confidence scores for echoes read positive for LVT in discordance with DE-CMR compared with echoes concordant with DE-CMR (p < 0.02). |
3 |
| 40. Pontone G, Di Cesare E, Castelletti S, et al. Appropriate use criteria for cardiovascular magnetic resonance imaging (CMR): SIC-SIRM position paper part 1 (ischemic and congenital heart diseases, cardio-oncology, cardiac masses and heart transplant). Radiol Med. 2021 Mar;126(3):365-379. |
Review/Other-Dx |
NA |
To provide appropriate use criteria for cardiovascular magnetic resonance imaging. |
No results listed in abstract. |
4 |
| 41. Balci AY, Sargin M, Akansel S, et al. The importance of mass diameter in decision-making for preoperative coronary angiography in myxoma patients. Interact Cardiovasc Thorac Surg. 2019 Jan 01;28(1):52-57. |
Review/Other-Dx |
46 patients |
To evaluate clinical experience and CAG findings in our patient group. |
Coronary artery disease defined as >50% obstructive lesions was detected in 10 patients (21.7%). The tumour diameter was found to be significantly higher in patients who had an ACF and a dual-feeding artery (P = 0.049 and P = 0.0001, respectively). Additionally, there was a significant relationship between the presence of dual-feeding vessels and ACF (P = 0.014). ROC analysis revealed a cut-off point of 27 mm in diameter based on the presence of an ACF and a dual-feeding artery. In cases with a diameter of 27 mm or above, the risk of existence of an ACF was 4.68-fold greater, with a confidence interval of 95%, and a dual-feeding pattern was seen in all of them. |
4 |
| 42. Lee SY, Lee SH, Jung SM, et al. Value of Coronary Angiography in the Cardiac Myxoma. Clin Anat. 2020 Sep;33(6):833-838. |
Observational-Dx |
42 patients |
To examine cardiac myxoma cases in two tertiary hospitals using coronary angiography to identify the artery feeding the myxoma. |
We retrospectively reviewed 42 patients with cardiac myxoma who had undergone surgical removal between July 2008 and December 2015 in two tertiary hospitals, and recorded their baseline characteristics, echocardiographic findings, and coronary angiography. Among those 42 patients, 23 (55%) had coronary angiography before surgery and in no case was significant luminal narrowing observed. In 21 of the coronary angiograms, the artery feeding the cardiac myxoma had a vascular branch (100%), clusters of tortuous vessels with contrast medium pooling (67%), an arteriocavity fistula (33%), and a mobile feeding artery (67%). No significant relationship was found between coronary artery dominance type and the origin of the artery feeding the cardiac myxoma (P = 0.362). |
3 |
| 43. Quan H, Liang P, Tan Y. The Value of Multi-slice CT Imaging in Cardiac Myxomas in Comparison with Follow-Up Screening in Thoracoscopic Surgery. Cell Biochem Biophys. 2015 Nov;73(2):565-569. |
Observational-Dx |
40 patients (26 males, 14 females) |
To evaluate the ability of multi-slice CT (MSCT) imaging for the diagnosis of cardiac myxomas (CMs) in comparison with follow-up screening in thoracoscopic surgery. |
40 consecutive patients who had CMs confirmed by thoracoscopic surgery underwent MSCT scanning. The radiological findings were analyzed to reveal the tumor location, appearance, size, pedicle diameter and originating, and compared with surgical outcomes in the follow-up studies. We found that the tumor location and appearance were all definitely diagnosed in the radiological findings and were consistent with the surgical outcomes with the coincidence rate of 100 %. All the tumors showed heterogeneous enhancement, with a pedicle originating from the atrial septum. Compared with the results of surgical outcomes, the accuracy of MSCT for measuring tumor size and pedicle diameter has no statistical difference. The results indicate that MSCT imaging provides a great incremental value for the diagnosis of CMs in comparison with follow-up screening in thoracoscopic surgery. |
3 |
| 44. Zou H, Zhang Y, Tong J, Liu Z. Multidetector computed tomography for detecting left atrial/left atrial appendage thrombus: a meta-analysis. Intern Med J. 2015 Oct;45(10):1044-53. |
Meta-analysis |
15 trials with 2540 patients |
To evaluate synthetically the diagnostic accuracy of multidetector computed tomography (MDCT) in left atrial/left atrial appendage (LA/LAA) thrombus. |
Fifteen prospective clinical controlled trials with 2540 patients fulfilled the inclusion criteria. The pooled sensitivities (SEN): 0.957; pooled specificities (SPE): 0.917; pooled positive likelihood ratio (PLR): 22.017; pooled negative likelihood ratio (NLR): 0.060; pooled diagnostic odds ratio (DOR): 437.43; the area under the curve (AUC): 0.9883; Q*-value: 0.9544. However, in the abovementioned indexes, the heterogeneities were statistically significant between studies (P < 0.05, inconsistency index (I(2) ) > 50%). In a sub-analysis of studies in which delayed imaging, electrocardiogram (ECG) gating and heart rate control were performed, not only the diagnostic accuracy, but also the heterogeneities were significantly improved (pooled SEN 0.991; pooled SPE 0.989; pooled PLR 60.768; pooled NLR 0.034; pooled DOR 2561.7; AUC 0.9972; Q*-value 0.9806; all the indexes' P-value were greater than 0.05 and the I(2) were 0%, except for SPE, I(2) = 54.6%). |
Good |
| 45. D'Angelo EC, Paolisso P, Vitale G, et al. Diagnostic Accuracy of Cardiac Computed Tomography and 18-F Fluorodeoxyglucose Positron Emission Tomography in Cardiac Masses. JACC Cardiovasc Imaging. 2020 Nov;13(11):S1936-878X(20)30331-4. |
Observational-Dx |
60 |
This study sought to assess the diagnostic accuracy of cardiac computed tomography (CT) and 18F-fluorodeoxyglucose (18F-FDG) with positron emission tomography/computed tomography (PET/CT) in defining the nature ofcardiac masses. |
Irregular tumor margins, pericardial effusion, invasion, solid nature, mass diameter, CT contrast uptake, and precontrast characteristics were strongly associated with the malignant nature of masses. The coexistence of at least 5 CT signs perfectly identified malignant masses, whereas the detection of 3 or 4 CT signs did not accurately discriminate the masses’ nature. The mean SUVmax, SUVmean, metabolic tumor volume, and total lesion glycolysis values were significantly higher in malignant than in benign masses. The diagnostic accuracy of SUV, metabolic tumor volume, and total lesion glycolysis 18FFDG PET/CT parameters was excellent in detecting malignant masses. Among patients with 3 or 4 pathological CT signs, the presence of at least 1 abnormal 18F-FDG PET/CT parameter significantly increased the identification of malignancies. |
3 |
| 46. Lemasle M, Lavie Badie Y, Cariou E, et al. Contribution and performance of multimodal imaging in the diagnosis and management of cardiac masses. Int J Cardiovasc Imaging. 2020 May;36(5):971-981. |
Observational-Dx |
119 |
To evaluate the contribution and performance of multimodal imaging in the diagnostic and therapeutic management of cardiac masses. |
All imaging modalities increased decision-making rates, which rose from 2 to 54%, 23 to 62%, 31 to 85% and 49 to 100% before and after TEE, CT, CMR and 18F-FDG PET-CT, respectively (P < 0.001 before vs. after). TEE was particularly efficient for atrial masses, especially for the left atrium, with a decision rate rising from 0 to 74% (P < 0.001). 18F-FDG PET-CT was the most efficient to differentiate benign and malignant etiologies (area under the curve 0.89 ± 0.06 and 0.94 ± 0.05 for benign and malignant, respectively, P < 0.001). A benign or undetermined result on each modality was associated with a good prognosis, compared to malignant. All modalities studied are useful for cardiac mass decision-making. First-line TEE is particularly efficient for atrial masses, whereas CT and CMR are useful for ventricular masses or suspicion of malignancy. A benign or malignant result for each modality is correlated to survival and 18F-FDG PET-CT is the most effective to define it. |
3 |
| 47. Hong YJ, Hur J, Kim YJ, et al. Dual-energy cardiac computed tomography for differentiating cardiac myxoma from thrombus. Int J Cardiovasc Imaging. 2014 Dec;30 Suppl 2():121-8. |
Experimental-Dx |
37 |
The purpose of this study was to evaluate the diagnostic value of dual-energy cardiac computed tomography (CCT) for differentiating cardiac myxomas from thrombi. |
We prospectively enrolled 37 patients who had an intra-cardiac mass on echocardiography or computed tomography (CT). All patients underwent dual-energy CCT. For quantitative analysis, the CT attenuation density and iodine concentration of the intra-cardiac mass were measured on CT images. The Mann-Whitney test was used to evaluate differences in the mean CT attenuation density and the mean iodine concentrations between the cardiac myxoma and thrombus groups. Pathological results or follow-up with echocardiography was used to make the final diagnosis. There were a total of 17 cardiac myxomas and 20 thrombi. On CT, the mean CT numbers were not significantly different between cardiac myxomas and cardiac thrombi (91.7 ± 11.6 HU vs. 85.2 ± 10.9 HU, respectively, P = 0.241), whereas, the mean iodine concentration (mg/ml) was significantly different between cardiac myxomas and cardiac thrombi (3.53 ± 0.72 vs. 1.37 ± 0.31, respectively, P < 0.001). Dual-energy CCT using a quantitative analytic methodology can be used to differentiate between cardiac myxomas and thrombi. |
2 |
| 48. Hong YJ, Hur J, Han K, et al. Quantitative Analysis of a Whole Cardiac Mass Using Dual-Energy Computed Tomography: Comparison with Conventional Computed Tomography and Magnetic Resonance Imaging. Sci Rep. 2018 Oct 18;8(1):15334. |
Observational-Dx |
41 patients |
This study aimed to assess the diagnostic value of a volume-based quantification strategy using dual-energy CT to differentiate between cardiac tumors and thrombi. |
For quantitative analysis, the following parameters of the entire cardiac masses were measured: CT attenuation values in Hounsfield units (HU), iodine concentration (mg/ml), and signal intensity (SI) ratio. A mixed effects model was used to evaluate the significance of differences in mean CT attenuation, mean iodine concentration, and SI ratios between the cardiac tumor and thrombus groups. Diagnostic performance of each parameter was evaluated by constructing a receiver operating characteristics curve. A total of 24 cardiac tumors and 19 cardiac thrombi were analyzed. The mean iodine concentration was significantly higher in tumors than in thrombi (tumors: 2.98 ± 0.23; thrombi: 1.79 ± 0.26, p = 0.002). The diagnostic performance of iodine concentration was better than that of post-contrast HU (area under the curve [AUC]: 0.77 vs. 0.51; p < 0.001), and worse than that of SI ratio (AUC: 0.89; p = 0.04) for differentiation of cardiac tumors and thrombi. Dual-energy CT using volume-based iodine measurements can differentiate between cardiac tumors and thrombi. |
3 |
| 49. Schulze M, Spira D, Claussen CD, Sauter A, Mayer F, Horger M. Characterization of incidental cardiac masses in oncological patients using a new CT-based tumor volume perfusion technique. Acta Radiol. 2013 Oct;54(8):895-903. |
Review/Other-Dx |
NA |
The purpose of this study was to review the existing spectrum of diagnostic modalities for characterization of cardiac masses in an oncologic patient cohort with emphasis on their strengths and limitations and to present the benefit from using the novel technique called VPCT for this purpose. |
No results listed in abstract. |
4 |
| 50. Lee JW, Park CH, Im DJ, et al. CT-based radiomics signature for differentiation between cardiac tumors and a thrombi: a retrospective, multicenter study. Sci Rep. 2022 May 17;12(1):8173. |
Observational-Dx |
192 patients |
The study aimed to develop and validate whether the computed tomography (CT) radiomics analysis is effective in differentiating cardiac tumors and thrombi. |
In the training dataset, the radiomics model and the combined model yielded significantly higher differentiation performance between cardiac tumors and cardiac thrombi than the clinical model (AUC 0.973 vs 0.870, p < 0.001 and AUC 0.983 vs 0.870, p < 0.001, respectively). In the external validation dataset with 63 patients (59.8 ± 13.2 years, 26 men), the combined model yielded a larger AUC compared to the clinical model (AUC 0.911 vs 0.802, p = 0.037). |
2 |
| 51. Tella SH, Jha A, Taïeb D, Horvath KA, Pacak K. Comprehensive review of evaluation and management of cardiac paragangliomas. Heart. 2020 Aug;106(16):1202-1210. |
Review/Other-Dx |
38 |
The objective of this comprehensive review is to provide most recent advancements and future directions in the molecular origins, genetic background, evaluation and contemporary management of cardiac PGLs. |
Cardiac paraganglioma (PGL) is a rare neuroendocrine tumour causing significant morbidity primarily due to norepinephrine secretion potentially causing severe hypertension, palpitations, lethal tachyarrhythmias, stroke and syncope. Cardiologists are faced with two clinical scenarios. The first is the elevated norepinephrine, whose actions must be properly counteracted by adrenoceptor blockade to avoid catastrophic consequences. The second is to evaluate the precise location of a cardiac PGL and its spread since compression of cardiovascular structures may result in ischaemia, angina, non-noradrenergic-induced arrhythmia, cardiac dysfunction or failure. Thus, appropriate assessment of elevated norepinephrine by its metabolite normetanephrine is a gold biochemical standard at present. Furthermore, dedicated cardiac CT, MRI and transthoracic echocardiogram are necessary for the precise anatomic information of cardiac PGL. Moreover, a cardiologist needs to be aware of advanced functional imaging using 68Ga-DOTA(0)-Tyr(3)-octreotide positron emission tomography/CT, which offers the best cardiac PGL-specific diagnostic accuracy and helps to stage and rule out metastasis, determining the next therapeutic strategies. Patients should also undergo genetic testing, especially for mutations in genes encoding succinate dehydrogenase enzyme subunits that are most commonly present as a genetic cause of these tumours. Curative surgical resection after appropriate a-adrenoceptor and ß-adrenoceptor blockade in norepinephrine-secreting tumours is the primary therapeutic strategy. Therefore, appropriate and up-to-date knowledge about early diagnosis and management of cardiac PGLs is paramount for optimal outcomes in patients where a cardiologist is an essential team member of a multidisciplinary team in its management. |
4 |
| 52. Carreras C, Kulkarni HR, Baum RP. Rare metastases detected by (68)Ga-somatostatin receptor PET/CT in patients with neuroendocrine tumors. Recent Results Cancer Res. 2013;194():379-84. |
Review/Other-Dx |
4,210 Ga-68 somatostatin-receptor PET/CT studies |
The most common sites of metastasis in neuroendocrine tumors are liver, lymph nodes, and bone. The aim of this study is to determine the prevalence and location of other sites of metastasis. |
The different sites of metastasis according to frequency of occurrence were: cardiac (n = 29), breast (n = 21), retro-orbital (n = 9), uterus (n = 7), skin (n = 8), brain (n = 6), spleen (n = 3), testes (n = 1), seminal vesicle (n = 1), and intramuscular in psoas muscle (n = 4). |
4 |
| 53. Kunz WG, Eschbach RS, Stahl R, et al. Identification and characterization of myocardial metastases in neuroendocrine tumor patients using 68Ga-DOTATATE PET-CT. Cancer Imaging. 2018 Sep 20;18(1):34. |
Review/Other-Dx |
629 |
Focal 68Ga-DOTATATE PET lesions within the myocardium of neuroendocrine tumor (NET) patients are observed in clinical practice. We determined the frequency and characteristics of lesions that are consistent with cardiac metastasis and assessed the lesion detection rate of conventional imaging |
The prevalence of myocardial metastases related to the registry was 2.4% (15 of 629 NET patients fulfilling the inclusion criteria), for a total of 21 myocardial 68Ga-DOTATATE foci detected. Myocardial lesions were most frequently located in the left ventricle (43%) and the septum (43%). No patient demonstrated a pericardial effusion. Patients with myocardial metastases did not differ in demographics, tumor grading, disease stage or circulating tumor markers compared to the overall registry (all p > 0.05). Higher Ki67-Indices were observed (p = 0.049) for patients with myocardial metastases. Interreader agreement for PET assessment was excellent (Cohen’s ? = 1.0). CT reading showed a sensitivity of 19% (95% confidence interval: 6–43%) at a specificity of 100% (95% confidence interval: 90–100%). |
4 |
| 54. Taïeb D, Hicks RJ, Hindié E, et al. European Association of Nuclear Medicine Practice Guideline/Society of Nuclear Medicine and Molecular Imaging Procedure Standard 2019 for radionuclide imaging of phaeochromocytoma and paraganglioma. Eur J Nucl Med Mol Imaging. 2019 Sep;46(10):2112-2137. |
Review/Other-Dx |
NA |
Diverse radionuclide imaging techniques are available for the diagnosis, staging, and follow-up of phaeochromocytoma and paraganglioma (PPGL). Beyond their ability to detect and localise the disease, these imaging approaches variably characterise these tumours at the cellular and molecular levels and can guide therapy. Here we present updated guidelines jointly approved by the EANM and SNMMI for assisting nuclear medicine practitioners in not only the selection and performance of currently available single-photon emission computed tomography and positron emission tomography procedures, but also the interpretation and reporting of the results. |
Since the European Association of Nuclear Medicine 2012 guidelines, the excellent results obtained with gallium-68 (68Ga)-labelled somatostatin analogues (SSAs) in recent years have simplified the imaging approach for PPGL patients that can also be used for selecting patients for peptide receptor radionuclide therapy as a potential alternative or complement to the traditional theranostic approach with iodine-123 (123I)/iodine-131 (131I)-labelled meta-iodobenzylguanidine. Genomic characterisation of subgroups with differing risk of lesion development and subsequent metastatic spread is refining the use of molecular imaging in the personalised approach to hereditary PPGL patients for detection, staging, and follow-up surveillance. |
4 |
| 55. Jann H, Wertenbruch T, Pape U, et al. A matter of the heart: myocardial metastases in neuroendocrine tumors. Horm Metab Res. 2010 Dec;42(13):967-76. |
Review/Other-Dx |
4 patients |
To evaluate frequency, clinical spectrum, and treatment of myocardial metastases in patients with histologically proven neuroendocrine tumors by analysis of our database and literature review. |
No results stated in abstract. |
4 |
| 56. Marketou ME, Kapsoritakis N, Bourogianni O, et al. Hybrid imaging of neuroendocrine tumors in the heart: Union is strength. J Nucl Cardiol. 2023 Feb;30(1):298-312. |
Review/Other-Dx |
N/A |
Cardiac neuroendocrine tumors (NETs) are particularly rare tumors that can lead to a very poor clinical outcome, partly because of metastases but mainly because of manifestations of the hormonal activity they exhibit. |
No results stated in abstract. |
4 |
| 57. Noordzij W, van Beek AP, Tio RA, et al. Myocardial metastases on 6-[18F] fluoro-L-DOPA PET/CT: a retrospective analysis of 116 serotonin producing neuroendocrine tumour patients. PLoS One. 2014;9(11):e112278. |
Review/Other-Dx |
116 patients who underwent 18F-FDOPA PET/CT |
To evaluate the prevalence of cardiac metastases in patients with serotonin producing neuroendocrine tumours (NET), examined with 18F-FDOPA PET/CT, and the relationship of these metastases to the presence of carcinoid heart disease (CHD) based on echocardiography. |
116 patients (62 male) underwent 18F-FDOPA PET/CT, mean age was 61±13 years. TTE was performed in 79 patients. Cardiac metastases were present in 15 patients, of which 10 patients also underwent TTE. One patient had both cardiac metastasis (only on 18F-FDOPA PET/CT) and echocardiographic signs of CHD. There were no differences in echocardiographic parameters for CHD between patients with and without cardiac metastases. TTE in none of the 79 patients showed cardiac metastases. |
4 |
| 58. Kim MS, Kim EK, Choi JY, Oh JK, Chang SA. Clinical Utility of [18F]FDG-PET /CT in Pericardial Disease. Curr Cardiol Rep. 2019 Aug 02;21(9):107. |
Review/Other-Dx |
N/A |
To review the clinical utility of [18F]-2-deoxy-2-fluoro-D-glucose positron emission tomography/computed tomography ([18F]FDG-PET/CT) in the diagnosis and treatment of pericardial disease. |
[18F]FDG-PET/CT can visualize the hypermetabolic tissues of both malignancy and inflammation. Distribution of [18F]FDG-PET/CT uptake can provide information for neoplastic disease. If malignancy is ruled out, high uptake of pericardium is associated with active inflammation of the pericardium, and thus response to anti-inflammatory agents can also be predicted with [18F]FDG-PET/CT imaging. |
4 |
| 59. Lau JM, Laforest R, Nensa F, Zheng J, Gropler RJ, Woodard PK. Cardiac Applications of PET/MR Imaging. Magn Reson Imaging Clin N Am. 2017 May;25(2):S1064-9689(16)30122-2. |
Review/Other-Dx |
N/A |
Discussion of the technical challenges specific to cardiovascular PET/MR imaging followed by a discussion of the use of PET/MR imaging in various cardiovascular conditions. |
No results stated in abstract. |
4 |
| 60. Qin C, Shao F, Hu F, et al. 18F-FDG PET/CT in diagnostic and prognostic evaluation of patients with cardiac masses: a retrospective study. Eur J Nucl Med Mol Imaging. 2020 May;47(5):1083-1093. |
Observational-Dx |
64 patients with 65 cardiac masses |
To evaluate the diagnostic and prognostic value of 18F-FDG PET/CT in patients with cardiac masses. |
Statistically significant differences in various morphological features and metabolic indices between benign and malignant masses were found. An SUVmax of 6.75 was the optimal cutoff value to differentiate between benign and malignant masses, and the diagnostic sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 92.11%, 88.89%, 90.77%, 92.11%, and 88.89%, respectively. Taking CT features and SUVmax = 6.75 as a criterion, the values were 76.32%, 100.00%, 86.15%, 100.00%, and 75.00%, respectively; taking = 3 CT features or SUVmax = 6.75 as a criterion, the values were 94.74%, 88.89%, 92.31%, 92.31%, and 92.31%, respectively, indicating optimal diagnostic performance when paired with the anatomic information provided by the CT component. A univariate analysis of OS determined that surrounding tissue infiltration, epicardial infiltration, necrosis, multiple chambers or vessel involvement, distant metastasis, SUVmax, SUVmean, metabolic tumour volume (MTV), and total lesion glycolysis (TLG) were significant predictors of survival. In the multivariate analysis, only SUVmax = 6.715 was significant (P < 0.01). Median OS was 1460 days for SUVmax < 6.715 and 342 days for SUVmax = 6.715 (P < 0.01). |
3 |
| 61. Meng J, Zhao H, Liu Y, et al. Assessment of cardiac tumors by 18F-FDG PET/CT imaging: Histological correlation and clinical outcomes. J Nucl Cardiol. 2021 Oct;28(5):2233-2243. |
Observational-Dx |
38 patients |
To evaluate the diagnostic value of 18F-FDG PET/CT in distinguishing benign versus malignant cardiac tumors as well as to assess its prognostic value. |
Optimal cut-off values indicating malignancy were as follows: SUVmax = 3.44, with 100% sensitivity and 92.9% specificity, and TBRmax = 1.55, with 95.8% sensitivity and 92.9% specificity. A significant difference of 18F-FDG uptake was observed between primary benign (n = 14, SUVmax = 2.35 ± 1.31, TBRmax = 1.05 ± 0.50) compared to primary malignant cardiac tumors (n = 11, SUVmax = 8.90 ± 4.23, TBRmax = 3.82 ± 1.44) as well as cardiac metastases and lymphoma (n = 13, SUVmax = 14.37 ± 8.05, TBRmax = 6.19 ± 3.38) (all P < .001). Survival rate was significantly lower in patients with malignant as compared to benign cardiac tumors (P < .05). Regression analysis revealed that the lesion dignity determined by the cut-off value of SUVmax was an independent predictor for death in patients with cardiac tumors (P < .05). |
3 |
| 62. Yin H, Mao W, Tan H, et al. Role of 18F-FDG PET/CT imaging in cardiac and pericardial masses. J Nucl Cardiol. 2022 Jun;29(3):1293-1303. |
Observational-Dx |
59 patients with newly diagnosed cardiac/pericardial masses |
To analyze the role of 18F-FDG PET/CT imaging in cardiac/pericardial masses. |
The McNemar test was used to test the differences in sensitivity between PET/CT and TTE. 18F-FDG PET/CT had higher sensitivity in determining the malignancy of cardiac/pericardial masses compared to TTE (sensitivity, 96.6% vs 72.4%, P = .039). However, when pericardial masses were excluded from the analysis, the difference in sensitivity between the two was not statistically significant (sensitivity, 95.6% vs 78.3%, P = .219). 18F-FDG PET/CT identified two malignant pericardial masses missed on TTE, changed the diagnostic orientation of TTE in 15 patients, and found seven patients with extracardiac lesions in 29 malignant patients. |
2 |
| 63. Rahbar K, Seifarth H, Schäfers M, et al. Differentiation of malignant and benign cardiac tumors using 18F-FDG PET/CT. J Nucl Med. 2012 Jun;53(6):856-63. |
Observational-Dx |
24 consecutive patients with newly diagnosed cardiac tumors: benign cardiac tumors (n = 7) and malignant cardiac tumors (n = 17) |
To evaluate the diagnostic value of (18)F-FDG PET and the incremental diagnostic value of an optimized CT score in this clinical scenario. |
Mean SUV(max) was 2.8 ± 0.6 in benign cardiac tumors and significantly higher both in malignant primary and in secondary cardiac tumors (8.0 ± 2.1 and 10.8 ± 4.9, P < 0.01). Malignancy was determined with a sensitivity of 100% and specificity of 86% (accuracy, 96%), after a cutoff with high sensitivity (SUV(max) of 3.5) was chosen to avoid false-negatives. Morphologic imaging reached a sensitivity of 82% and a specificity of 86% (accuracy, 83%). Both false-positive and false-negative decisions in morphology could be corrected in all but 1 case using a metabolic threshold with an SUV(max) of 3.5. In addition, extracardiac tumor manifestations were detected in 4 patients by whole-body (18)F-FDG PET/CT. |
3 |
| 64. Liu E, Huang J, Dong H, et al. Diagnostic challenges in primary cardiac lymphoma, the opportunity of 18F-FDG PET/CT integrated with contrast-enhanced CT. J Nucl Cardiol. 2022 Oct;29(5):2378-2389. |
Observational-Dx |
17 patients |
The purpose of this study was to retrospectively evaluate the value of 18FFDG PET/CT integrated with contrast-enhanced CT (CECT) in the differential diagnosis ofprimary cardiac lymphomas (PCLs) and primary cardiac angiosarcomas (PCAs). |
Nine patients with PCL and eight patients with PCA were analyzed. There were significant differences in SUVmax (t = 3.790, P = .002), SUVmean (t = 4.273, P = .001), metabolic tumor volume (U = 13.00, P = .027), tumor-to-liver ratio (U = 10.00, P = .011), and total lesion glycolysis (U = 4.0, P = .001) between PCLs and PC18As. There were significant differences in the enhancement pattern of tumors (P = .002) and tumor morphology (P = .015). The combination of F-FDG PET/CT and CECT improved the diagnostic accuracy, and the combination cutoff (SUVmean > 5.17) could reach 100%, but the difference was not statistically significant (P > .05). |
3 |
| 65. Khanal K, Khadka A, Singh A, Singh S. Assessing the Role of 18F-FDG PET/CT in the Diagnosis and Prognosis of Cardiac Tumors. Journal of Nuclear Medicine 2024;65:241361-61. |
Review/Other-Dx |
NA |
To assess 18F-FDG PET/CT's role in cardiac tumor evaluation, we reviewed and synthesized information from highly cited articles of the past decade, indexed in PubMed and Google Scholar. |
The application of 18 F-FDG PET/CT in cardiac tumor identification, despite the challenge posed by the high physiological uptake of 18 F-FDG in the myocardium, is gaining traction for its precision in evaluating both benign and malignant tumors. This technique relies on the maximum standardized uptake value (SUVmax) as a critical indicator, with a threshold of over 10 suggesting malignancy, while a value under 3.5 typically indicates benignity. An analysis of seven studies encompassing 469 patients demonstrated that 18 F-FDG PET/CT can effectively differentiate between benign and malignant cardiac tumors using the SUVmax criterion, where higher values are significantly associated with malignancy (p<0.05). In terms of diagnostic accuracy, 18 F-FDG PET/CT has shown a sensitivity range of 92% to 100% and specificity between 84% and 92% in detecting malignant cardiac tumors. This high level of sensitivity and specificity underscores its clinical value in this niche yet critical area. Moreover, 18 F-FDG PET/CT is not just limited to tumor detection but also extends to staging malignancies, particularly useful for identifying pericardial and myocardial involvement, sometimes surpassing the performance of contrast-enhanced computed tomography (CECT) in staging cardiac tumors. Additionally, 18 F-FDG PET/CT has prognostic value. SUVmax has been identified as an independent prognostic factor for overall survival in patients with cardiac tumors. Studies indicate that patients with higher SUVmax values have a significantly different median overall survival, suggesting that this metric can be instrumental in predicting patient outcomes. This multifaceted utility of 18 F-FDG PET/CT, from diagnosis and staging to prognostication, highlights its growing importance in the comprehensive management of cardiac tumors. |
4 |
| 66. Yuan H, Qiu J, Chiu KWH, et al. PET/CT morphology and cardiac conduction disorders help discriminate primary cardiac lymphoma from primary cardiac sarcoma. J Nucl Cardiol. 2022 Dec;29(6):2866-2877. |
Review/Other-Dx |
29 patients |
To explore the role of PET morphology and clinical characteristics in distinguishing PCL from PCS. |
Compared with PCS, PCL occurred at an older age, resulted in more cardiac dysfunctions and arrhythmias, and showed higher glucometabolism (SUVmax, SUVpeak, SUVmean, MTV, and TLG). Curative treatments improved survival for PCL but not for PCS. Multivariable logistic regression identified R_Kurtosis (OR = 27.025, P = .007) and cardiac conduction disorders (OR = 37.732, P = .016) independently predictive of PCL, and classification and regression tree analysis stratified patients into three subgroups: R_Kurtosis = 0.044 (probability of PCL 88.9%), R_Kurtosis < 0.044 with conduction disorders (80.0%), and R_Kurtosis < 0.044 without conduction disorders (13.3%). |
4 |
| 67. Chan AT, Fox J, Perez Johnston R, et al. Late Gadolinium Enhancement Cardiac Magnetic Resonance Tissue Characterization for Cancer-Associated Cardiac Masses: Metabolic and Prognostic Manifestations in Relation to Whole-Body Positron Emission Tomography. J Am Heart Assoc. 2019 May 21;8(10):e011709. |
Observational-Dx |
121 cancer patients who underwent CMR and 18F-FDG–PET |
(1) to determine whether differences in CMR-evidenced contrast enhancement between neoplasm and thrombus parallel differential metabolism on PET(2) to identify factors affecting performance of visual and quantitative PET in relation to the reference of CMR(3) to assess whether differential detection of cardiac masses by CMR and PET affects their relative utility for prognostic risk stratification. |
Of CMR -evidenced thrombi (all nonenhancing), none were detected by PET . For neoplasm, PET yielded reasonable sensitivity (70-83%) and specificity (75-88%). Lesions undetected by PET were more likely to be highly mobile ( P=0.001) despite similar size ( P=0.33). Among nonmobile neoplasms, PET sensitivity varied in relation to extent of CMR -evidenced avascularity; detection of diffusely enhancing or mixed lesions was higher versus predominantly avascular neoplasms (87% versus 63%). Colocalized analyses demonstrated 2- to 4-fold higher FDG uptake in neoplasm versus thrombus ( P<0.001); FDG uptake decreased stepwise when neoplasms were partitioned based on extent of avascularity on late gadolinium enhancement CMR ( P=0.001). Among patients with neoplasm, signal-to-noise ratio on late gadolinium enhancement CMR moderately correlated with standardized uptake values on PET ( r=0.42-0.49, P<0.05). Mortality was higher among patients with CMR -evidenced neoplasm versus controls (hazard ratio: 1.99 [95% CI, 1.1-3.6]; P=0.03) despite nonsignificant differences when partitioned via FDG avidity (hazard ratio: 1.56 [95% CI, 0.85-2.74]; P=0.16). Among FDG-positive neoplasms detected concordantly with CMR , mortality risk versus cancer-matched controls was equivalently increased (hazard ratio: 2.12 [95% CI, 1.01-4.44]; P=0.047). |
2 |
| 68. Gripari P, Pepi M, Fusini L, et al. Cardiac tumors: imaging findings, clinical correlations and surgical treatment in a 15 years single-center experience. J Cardiovasc Surg (Torino). 2022 Apr;63(2):212-221. |
Review/Other-Dx |
86 patients |
To present the clinical and pathological characteristics of cardiac tumors in a single-center series of patients; to describe the association of imaging characteristics, clinical presentation and surgical treatment; to analyze if second level imaging tests, computed tomography (CT) and cardiac magnetic resonance (CMR); and to improve the diagnostic accuracy when compared to first-line imaging technique (transthoracic echocardiography [TTE]). |
The majority were benign tumors (81%) with myxoma accounting for 66% of cases. Among malignancies, metastasis (8%) and primary tumors (10%) were equally recognized. Symptoms at presentation (45% of patients) were associated to larger diameters at TTE. Malignancies were larger (mean diameter 37±14 mm vs. 27±13 mm, P<0.01), more frequently exhibited irregular shape (67% vs. 17%, P<0.01), frayed or polylobulated surface (73% vs. 38%, P=0.035), heterogeneous aspect (67% vs. 32%, P=0.012). A maximum diameter >28 mm and a minimum diameter >19.5 mm emerged as possible cut-off values for the differentiation of benign and malignant tumors. The ability of TTE, CT and CMR features in identifying malignancies was moderate (diagnostic accuracy of 84%, 81%, 76% respectively). The mean survival time after surgery was 1.6±1.4 years in malignancies and 6.8±4.7 years in benign tumors. |
4 |
| 69. Aghayev A, Cheezum MK, Steigner ML, et al. Multimodality imaging to distinguish between benign and malignant cardiac masses. J Nucl Cardiol. 2022 Aug;29(4):1504-1517. |
Observational-Dx |
284 patients |
To compare the diagnostic accuracy of Cardiac Magnetic Resonance (CMR) imaging and fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) and their complementary role to distinguish benign vs malignant cardiac masses. |
72 patients who had CMR and FDG-PET/CT were included. 25 patients (35%) were diagnosed with benign and 47 (65%) were diagnosed with malignant masses. 56 patients had histological correlation: 9 benign and 47 malignant masses. CMR and FDG-PET/CT had a high accuracy in differentiating benign vs malignant masses, with the presence of CMR features demonstrating a higher sensitivity (98%), while FDG uptake with SUVmax/blood pool = 3.0 demonstrating a high specificity (88%). Combining multiple (> 4) CMR features and FDG uptake (SUVmax/blood pool ratio = 3.0) yielded a sensitivity of 85% and specificity of 88% to diagnose malignant masses. Over a mean follow-up of 2.6 years (IQR 0.3-3.8 years), risk-adjusted mortality were highest among patients with an infiltrative border on CMR (adjusted HR 3.1; 95% CI 1.5-6.5; P = .002) or focal extracardiac FDG uptake (adjusted HR 3.8; 95% CI 1.9-7.7; P < .001). |
3 |
| 70. Nensa F, Tezgah E, Poeppel TD, et al. Integrated 18F-FDG PET/MR imaging in the assessment of cardiac masses: a pilot study. J Nucl Med. 2015 Feb;56(2):255-60. |
Observational-Dx |
20 patients |
The objective of the present study was to evaluate whether integrated (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/magnetic resonance (MR) imaging could improve the diagnostic workup in patients with cardiac masses. |
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 (SUVmax) in malignant lesions was significantly higher than in nonmalignant cases (13.2 ± 6.2 vs. 2.3 ± 1.2, P = 0.0004). When a threshold of 5.2 or greater was used, SUVmax 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 SUVmax of 5.2 or greater with consent MR image interpretation improved sensitivity and specificity to 100%. |
2 |
| 71. Pontone G, Di Bella G, Castelletti S, et al. Clinical recommendations of cardiac magnetic resonance, Part II: inflammatory and congenital heart disease, cardiomyopathies and cardiac tumors: a position paper of the working group 'Applicazioni della Risonanza Magnetica' of the Italian Society of Cardiology. J Cardiovasc Med (Hagerstown). 2017 Apr;18(4):209-222. |
Review/Other-Dx |
N/A |
The working group on the ‘application of cardiac magnetic resonance’ of the Italian Society of Cardiology provided a perspective on the current state of technical advances and clinical cardiac magnetic resonance applications and to inform cardiologists how to implement their clinical and diagnostic pathway with the introduction of this technique in the clinical practice. |
No results stated in the abstract. |
4 |
| 72. Hong YJ, Hur J, Kim YJ, et al. The usefulness of delayed contrast-enhanced cardiovascular magnetic resonance imaging in differentiating cardiac tumors from thrombi in stroke patients. Int J Cardiovasc Imaging. 2011 Dec;27 Suppl 1():89-95. |
Review/Other-Dx |
22 patients |
To evaluate the diagnostic value of delayed-enhancement cardiovascular magnetic resonance (DE-CMR) imaging in differentiating cardiac tumors from thrombi in patients with suspected cardio-embolic stroke. |
Six cardiac tumors and 16 thrombi were confirmed on surgery or follow-up examinations. On DE-CMR, a tumor was defined as an intracardiac mass showing post-contrast enhancement, and a thrombus was defined as an intracardiac mass showing black signal intensity (SI) without post-contrast enhancement. The mean SI in regions of interest in the normal myocardium and cardiac mass were measured using cine-CMR and DE-CMR. Visual assessment of enhancement characteristics of cardiac masses on DE-CMR could accurately differentiate cardiac tumors from thrombi in all cases. On cine-CMR, the mean SI ratios for tumors and thrombi were 1.45 ± 0.45 (range, 1.12-2.16) and 1.39 ± 0.33 (range, 0.87-2.09), respectively (P = 0.745). On DE-CMR, the mean SI ratios for tumors and thrombi were 5.65 ± 2.96 (range, 2.98-9.92) and 1.06 ± 0.43 (range, 0.67-1.95), respectively (P < 0.001). |
4 |
| 73. Kitkungvan D, Nabi F, Ghosn MG, et al. Detection of LA and LAA Thrombus by CMR in Patients Referred for Pulmonary Vein Isolation. JACC Cardiovasc Imaging. 2016 Jul;9(7):S1936-878X(16)30219-4. |
Observational-Dx |
261 patients |
To evaluate the diagnostic performance of a comprehensive, multicomponent cardiac magnetic resonance (CMR) study for assessment of left atrial (LA) and left atrial appendage (LAA) thrombus. |
During the study period, 261 patients were assessed. The median CHA2DS2VASc (congestive heart failure, hypertension, age =75 years, diabetes mellitus, stroke/transient ischemic attack, vascular disease, age 65 to 74 years, sex category) score was 2, and 73.6% of patients were undergoing anticoagulation therapy. CMR and TEE were performed within 1.3 ± 2.3 days. LA/LAA thrombi were discovered in 9 patients (3.5%) by using TEE. Among the CMR techniques performed, long TI DE-CMR had the highest diagnostic accuracy (99.2%), sensitivity (100%), and specificity (99.2%), followed by contrast-enhanced magnetic resonance angiography (accuracy 94.3%; sensitivity 66.7%; and specificity 95.2%) and cine-CMR (accuracy 91.6%; sensitivity 66.7%; and specificity 92.5%). |
3 |
| 74. Slonimsky E, Konen O, Di Segni E, Konen E, Goitein O. Cardiac MRI: A Useful Tool for Differentiating Cardiac Thrombi from Tumors. Isr Med Assoc J. 2018 Aug;20(8):472-475. |
Observational-Dx |
101 |
To evaluate the diagnostic performances of cardiac magnetic resonance imaging (CMR) in differentiating between cardiac thrombi and tumors. |
CMR did not detect any cardiac pathology in 17% (17/101), including detection of anatomical variants and benign findings in 18% (15/84). Of the remaining 69 patients, CMR diagnosis was correlated with histopathologic result in 74% (51/69), imaging follow-upin 22% (15/69), and a definite CMR diagnosis (lipoma) in 4% (3/69). For tumors, diagnostic accuracy, sensitivity, specificity, PPV, and NPV were 96.6%, 98%, 86.6%, 96.2%, and 96.6%, respectively. For thrombi, the results were 93.6%, 86.7%, 98.04%, 92.9%, and 97%, respectively. |
2 |
| 75. Tumma R, Dong W, Wang J, Litt H, Han Y. Evaluation of cardiac masses by CMR-strengths and pitfalls: a tertiary center experience. Int J Cardiovasc Imaging. 2016 Jun;32(6):913-20. |
Review/Other-Dx |
249 |
To understand the diagnostic value of CMR for evaluation of suspected cardiac mass. |
More than half of the patients referred for evaluation of masses found at echocardiography or CT were found to have no evidence of mass by CMR. CMR correctly differentiated between thrombus and myxoma in 88.4 % cases. Malignant masses were accurately diagnosed on CMR. However, CMR missed or misdiagnosed a few cases of benign masses. Diagnosing cardiac masses remains an important use for imaging, despite technical difficulties with current imaging modalities. CMR can play a key role in confirming presence or absence of a mass. Additionally, in the presence of a mass, CMR can provide accurate differentiation of pseudomasses, benign and malignant masses. However, the limitations of CMR must be recognized. |
4 |
| 76. Pun SC, Plodkowski A, Matasar MJ, et al. Pattern and Prognostic Implications of Cardiac Metastases Among Patients With Advanced Systemic Cancer Assessed With Cardiac Magnetic Resonance Imaging. J Am Heart Assoc. 2016 May 04;5(5):e003368. |
Observational-Dx |
60 patients with stage IV cancer |
Cardiac magnetic resonance (CMR) imaging is well validated for tissue characterization of cardiac masses but has not been applied to study pattern and prognostic implications of cardiac metastases (CMETs) among patients with systemic cancer. |
CMET-positive patients and controls had similar clinical characteristics, cardiac geometry, and function (P=NS). Leading cancer types associated with CMET were sarcoma, melanoma, and gastrointestinal. Patients with CMETs had similar distribution of extracardiac metastatic disease compared with controls (organs involved: 3.4±2.0 versus 2.7±1.9, P=0.17). In 94% of patients with CMETs, there were metastases involving =1 extracardiac organ (66% lung involvement). CMET location varied (right ventricle 44%, right atrium 19%, left ventricle 28%, left atrium 9%, pericardial 25%); 22% of cases had multichamber involvement. Right-sided chamber involvement was common in hematologic/lymphatic spread (67%); pericardial involvement was common with direct spread (64%). Regarding tissue properties on delayed enhancement CMR, CMETs commonly (59%) demonstrated heterogeneous enhancement (41% diffuse enhancement). Heterogeneous lesions were larger and had increased border irregularity (P<0.05). Survival 6 months post-CMR was numerically lower among patients with CMETs (56% [95% CI 39–74%]) versus stage IV cancer–matched controls (68% [95% CI 50–86%]), although differences between groups were nonsignificant (P=0.42). |
2 |
| 77. Kassi M, Polsani V, Schutt RC, et al. Differentiating benign from malignant cardiac tumors with cardiac magnetic resonance imaging. J Thorac Cardiovasc Surg. 2019 May;157(5):S0022-5223(18)32561-3. |
Observational-Dx |
130 |
To describe the differences in cardiac magnetic resonance characteristics between benign and malignant tumors, which would be helpful for surgical planning. |
Of the 66 patients, 39 (59.0%) had malignant tumors and 27 (41.0%) had benign tumors. Patients with malignant tumors were younger when compared with those with benign tumors (age 51 years [42.8-60.0] vs 65 years [60.0-71.0] median). Malignant tumors more often demonstrated tumor invasion (69%vs 0% P<.001) and were more often associated with pericardial effusion (41%vs 7.4% P ¼ .004). Presence of first-pass perfusion (100% vs 33% P<.001) and late gadolinium enhancement (100% vs 59.2%, P<.001) were significantly higher in malignant tumors. In logistic regression modeling, tumor invasion (P<.001) and first-pass perfusion (P < .001) were independently associated with malignancy. Furthermore, using classification and regression tree analysis, we developed a decision tree algorithm to help differentiate benign from malignant tumors (diagnostic accuracy 90%). The algorithm-weighted cost of misclassifying a malignant tumor as benign was twice that of classifying a benign tumor as malignant. |
2 |
| 78. Mousavi N, Cheezum MK, Aghayev A, et al. Assessment of Cardiac Masses by Cardiac Magnetic Resonance Imaging: Histological Correlation and Clinical Outcomes. J Am Heart Assoc. 2019 Jan 08;8(1):e007829. |
Observational-Dx |
8069 patients |
To describe the distribution and imaging characteristics of cardiac masses identified by CMR and to determine the diagnostic accuracy of CMR for distinguishing benign from malignant tumors. |
Of 8069 patients (mean age: 58+/-16 years; 55% female) undergoing CMR, 145 (1.8%) had a cardiac mass. In most cases (142, 98%), there was a known cardiac mass before the CMR study. Among 145 patients with a cardiac mass, 93 (64%) had aknown history of malignancy. Among 53 cases that had histological correlation, 25 (47%) were benign, 26 (49%) were metastatic, and 2 (4%) were malignant primary cardiac masses. Blinded readers correctly diagnosed 89% to 94% of the cases as benign versus malignant, with a 95% agreement rate (j=0.83). |
2 |
| 79. Shenoy C, Grizzard JD, Shah DJ, et al. Cardiovascular magnetic resonance imaging in suspected cardiac tumour: a multicentre outcomes study. Eur Heart J. 2021 Dec 28;43(1):71-80. |
Review/Other-Dx |
935 |
Cardiovascular magnetic resonance (CMR) imaging is a key diagnostic tool for the evaluation of patients with suspected cardiac tumours. Patient management is guided by the CMR diagnosis, including no further testing if a mass is excluded or if only a pseudomass is found. However, there are no outcomes studies validating this approach. |
In this multicentre study of patients undergoing clinical CMR for suspected cardiac tumour, CMR diagnoses were assigned as no mass, pseudomass, thrombus, benign tumour, or malignant tumour. A final diagnosis was determined after follow-up using all available data. The primary endpoint was all-cause mortality. Among 903 patients, the CMR diagnosis was no mass in 25%, pseudomass in 16%, thrombus in 16%, benign tumour in 17%, and malignant tumour in 23%. Over a median of 4.9 years, 376 patients died. Compared with the final diagnosis, the CMR diagnosis was accurate in 98.4% of patients. Patients with CMR diagnoses of pseudomass and benign tumour had similar mortality to those with no mass, whereas those with malignant tumour [hazard ratio (HR) 3.31 (2.40-4.57)] and thrombus [HR 1.46 (1.00-2.11)] had greater mortality. The CMR diagnosis provided incremental prognostic value over clinical factors including left ventricular ejection fraction, coronary artery disease, and history of extracardiac malignancy (P < 0.001). |
4 |
| 80. Patel R, Lim RP, Saric M, et al. Diagnostic Performance of Cardiac Magnetic Resonance Imaging and Echocardiography in Evaluation of Cardiac and Paracardiac Masses. Am J Cardiol. 2016 Jan 01;117(1):S0002-9149(15)02091-3. |
Review/Other-Dx |
171 |
The primary objective of this study was to evaluate the predictive value of echocardiography and cardiac magnetic resonance (CMR) imaging parameters to identify cardiac tumors and malignant masses (Table 1),1 as well as to diagnosethe histopathology for cardiac masses using histologic confirmation as the gold standard. |
Fifty patients who underwent CMR evaluation of a cardiac mass with subsequent histopathologic diagnosis were identified. Echocardiography was available in 44 of 50 cases (88%). Echocardiographic and CMR characteristics were evaluated for predictive value in distinguishing tumor versus nontumor and malignant versus nonmalignant lesions using histopathology as the gold standard. The Wilcoxon rank-sum test was used to compare the 2 imaging methods' ability to provide the correct histopathologic diagnosis. Parameters associated with tumor included location outside the right atrium, T2 hyperintensity, and contrast enhancement. Parameters associated with malignancy included location outside the cardiac chambers, nonmobility, pericardial effusion, myocardial invasion, and contrast enhancement. CMR identified 6 masses missed on transthoracic echocardiography (4 of which were outside the heart) and provided significantly more correct histopathologic diagnoses compared to echocardiography (77% vs 43%, p <0.0001). In conclusion, CMR offers the advantage of identifying paracardiac masses and providing crucial information on histopathology of cardiac masses. |
4 |
| 81. Giusca S, Mereles D, Ochs A, et al. Incremental value of cardiac magnetic resonance for the evaluation of cardiac tumors in adults: experience of a high volume tertiary cardiology centre. Int J Cardiovasc Imaging. 2017 Jun;33(6):879-888. |
Review/Other-Dx |
125 |
To assess the value of cardiac magnetic resonance imaging (CMR) in evaluating cardiac tumours in a tertiary cardiology centre. |
In 65 pts., a diagnosis of cardiac tumour was reached. 45 Pts had a biopsy. The CMR examination was concordant with the histology results in 35 (76%) pts. superior to that showed by echocardiography, 26 (58%) pts., p = 0.03. Forty-two (65%) pts. had a benign tumour and 23 (35%) a malignant process. Myxoma was the most frequent benign tumour, 27 (65%) and cardiac metastases were the most frequent form of malignancies, 21 (91%), with B cell non-Hodgkin lymphoma being the most frequent one, 4 (19%). Benign tumours were mostly located in the left atrium, 27 (64%) versus 6 (26%), p = 0.007, whereas malignant tumours had a predilection for the right atrium und left ventricle [11 (48%) vs. 3 (7%), p = 0.001 and 8 (35%) vs. 3 (7%), p = 0.03]. All benign cardiac tumours were single and did not show signs of infiltration. Conversely, malignant cardiac tumours were larger (43 ± 35 vs. 24 ± 16, p = 0.007) with a significant proportion (65%) showing myocardial infiltration. Pts with malignant cardiac tumours had a higher proportion of LGE (82 vs. 60%, p = 0.05) and exhibited more frequently an isointense signal in T1 BB images (78 vs. 61%, p = 0.04). Both groups showed similar proportion of perfusion and signal intensity in the T2 BB acquisitions (p = NS). CMR is a valuable tool in evaluating cardiac tumours, proving superior to echocardiography in establishing the type of cardiac tumour. |
4 |
| 82. Matsumura M, Takamoto S, Kyo S, Yokote Y, Omoto R. [Advantages of transesophageal color Doppler echocardiography in the diagnosis and surgical treatment of cardiac masses]. J Cardiol. 1990;20(3):701-14. |
Review/Other-Dx |
N/A |
To determine the clinical advantages of transesophageal color Doppler echocardiography (TEE) for imaging cardiac tumors and left atrial thrombi, 24 cases with intra- or extracardiac masses were examined by transthoracic color Doppler echocardiography (TTE) and TEE before and after cardiac surgery. |
No results stated in abstract. |
4 |
| 83. Paolisso P, Bergamaschi L, Angeli F, et al. Cardiac Magnetic Resonance to Predict Cardiac Mass Malignancy: The CMR Mass Score. Circ Cardiovasc Imaging. 2024 Mar;17(3):e016115. |
Observational-Dx |
167 consecutive patients |
to develop a cardiac magnetic resonance (CMR)-derived model including mass localization, morphology, and tissue characterization to predict malignancy (with histology as gold standard), to compare its accuracy versus the diagnostic echocardiographic mass score, and to evaluate its prognostic ability. |
In CMR, mass morphological features (non-left localization, sessile, polylobate, inhomogeneity, infiltration, and pericardial effusion) and mass tissue characterization features (first-pass perfusion and heterogeneity enhancement) were independent predictors of malignancy. The CMR mass score (range, 0-8 and cutoff, =5), including sessile appearance, polylobate shape, infiltration, pericardial effusion, first-pass contrast perfusion, and heterogeneity enhancement, showed excellent accuracy in predicting malignancy (areas under the curve, 0.976 [95% CI, 0.96-0.99]), significantly higher than diagnostic echocardiographic mass score (areas under the curve, 0.932; P=0.040). The agreement between the diagnostic echocardiographic mass and CMR mass scores was good (?=0.66). A CMR mass score of =5 predicted a higher risk of all-cause death (P<0.001; hazard ratio, 5.70) at follow-up. |
2 |
| 84. Caspar T, El Ghannudi S, Ohana M, et al. Magnetic resonance evaluation of cardiac thrombi and masses by T1 and T2 mapping: an observational study. Int J Cardiovasc Imaging. 2017 Apr;33(4):551-559. |
Review/Other-Dx |
41 patients |
To evaluate CMR T1 and T2 mapping sequences in patients with intracardiac thrombi and masses in order to assess T1 and T2 relaxometry usefulness and to allow better etiological diagnosis. |
41 patients were included. 22 presented with cardiac thrombi and 19 with cardiac masses. The native T1 of thrombi was 1037 ± 152 ms (vs 1032 ± 39 ms for myocardium, p = 0.88; vs 1565 ± 88 ms for blood pool, p < 0.0001). T2 were 74 ± 13 ms (vs 51 ± 3 ms for myocardium, p < 0.0001; vs 170 ± 32 ms for blood pool, p < 0.0001). Recent thrombi had a native T1 shorter than old thrombi (911 ± 177 vs 1169 ± 107 ms, p = 0.01). The masses having a shorter T1 than the myocardium were lipomas (278 ± 29 ms), calcifications (621 ± 218 ms), and melanoma (736 ms). All other masses showed T1 values higher than myocardial T1, with T2 consistently >70 ms. T1 and T2 mapping CMR sequences can be useful and represent a new approach for the evaluation of cardiac thrombi and masses. |
4 |
| 85. Son J, Hong YJ, Kim S, et al. Radiomics Feature Analysis Using Native T1 Mapping for Discriminating Between Cardiac Tumors and Thrombi. Acad Radiol. 2022 Apr;29 Suppl 4():S1076-6332(20)30702-9. |
Observational-Dx |
41 patients |
To examine the diagnostic performance of radiomics features for differentiating cardiac tumors from thrombi using cardiac magnetic resonance imaging T1 mapping technique compared to that of late gadolinium enhancement (LGE) imaging. |
The area under the receiver operating characteristic curve of the rad score was higher than that of the mean T1 and LGE ratio (0.98 vs. 0.86 vs. 0.82, p = 0.001). With the optimal cut-off value, the rad score showed sensitivity, specificity, and accuracy of 95.4%, 95.2%, and 95.2%, respectively. Combination of the rad score and mean T1 showed a significantly higher diagnostic performance than mean T1 (p = 0.019) or LGE ratio (p = 0.022). |
2 |
| 86. Zaragoza-Macias E, Chen MA, Gill EA. Real time three-dimensional echocardiography evaluation of intracardiac masses. Echocardiography. 2012 Feb;29(2):207-19. |
Review/Other-Dx |
N/A |
To discuss the subject of real time three-dimensional echocardiography (RT3DE) evaluation of cardiac masses is reviewed and discussed in detail. |
No results available in the abstract. |
4 |
| 87. Bhattacharyya S, Khattar R, Senior R. Characterisation of intra-cardiac masses by myocardial contrast echocardiography. Int J Cardiol. 2013 Feb 10;163(1):S0167-5273(12)00889-3. |
Review/Other-Dx |
2 patients |
This case report illustrates the clinical application of myocardial contrast echocardiography as a tool to help differentiate between vascular tumour and avascular thrombus. |
No abstract available. |
4 |
| 88. Pino PG, Moreo A, Lestuzzi C. Differential diagnosis of cardiac tumors: General consideration and echocardiographic approach. J Clin Ultrasound. 2022 Oct;50(8):1177-1193. |
Review/Other-Dx |
N/A |
To describe the echocardiographic aspects of benign and malignant cardiac tumors |
No results stated in abstract. |
4 |
| 89. Paolisso P, Foà A, Bergamaschi L, et al. Echocardiographic Markers in the Diagnosis of Cardiac Masses. J Am Soc Echocardiogr. 2023 May;36(5):S0894-7317(23)00002-0. |
Observational-Dx |
286 |
The aim of this study was to identify and integrate the echocardiographic features of CMs that can accurately predict malignancy. |
Benign masses were more frequently pedunculated, mobile, and adherent to the interatrial septum (P < .001). Malignant masses showed a greater diameter and exhibited a higher frequency of irregular margins, an inhomogeneous appearance, sessile implantation, polylobate shape, and pericardial effusion (P < .001). Infiltration, moderate to severe pericardial effusion, nonleft localization, sessile implantation, polylobate shape, and inhomogeneity were confirmed to be independent predictors of malignancy in both univariate and multivariable models. The predictive ability of the unweighted score of =3 was very high (>0.90) and similar to that of the previously published weighted score. Classification tree analysis generated an algorithm in which infiltration was the best discriminator of malignancy, followed by nonleft localization and sessile implantation. The percentage correctly classified by classification tree analysis as malignant was 87.5%. Agreement between observer readings and CM histology ranged between 85.1% and 91.5%. The presence of at least three echocardiographic parameters was associated with lower survival. |
3 |
| 90. Nomoto N, Tani T, Konda T, et al. Primary and metastatic cardiac tumors: echocardiographic diagnosis, treatment and prognosis in a 15-years single center study. J Cardiothorac Surg. 2017 Nov 28;12(1):103. |
Observational-Dx |
95 |
To investigate the characteristics and locations of cardiac tumors and to provide a prognostic analysis in our hospital. |
The subjects included 56 men and 39 women with a mean age of 65 years. Clinical diagnosis revealed primary tumors in 61 patients (64%) and secondary metastatic tumors in 34 patients (36%). In the 61 patients, 41 patients (67%) underwent surgery and tissue samples were obtained. Of these 41 patients, benign tumors were found in 30 cases (73%). One patient (2%) was diagnosed with thrombus. Among the benign tumors, myxoma (67%) was the most common type followed by papillary fibroelastoma (23%). The most common site was the left atrium (35%) followed by the right atrium (25%). Primary malignant tumors were diagnosed in 10 cases (24%), including 6 angiosarcomas, 3 lymphomas, and 1 leiomyosarcoma. The diagnostic accuracy of echocardiography was 80%. The patients with benign tumors were all alive at the end of the follow-up period. In contrast, 7 patients with malignant tumors died (70%) (p < 0.0001). |
3 |
| 91. Barchitta A, Basso C, Piovesana PG, et al. Opacification patterns of cardiac masses using low-mechanical index contrast echocardiography: comparison with histopathological findings. Cardiovasc Pathol. 2017;30():S1054-8807(17)30143-6. |
Observational-Dx |
12 |
The aim of the study was to assess the ability of low mechanical index (MI) contrast echocardiography to detect presence and amount of tissue vascularization as validated by histopathology study of cardiac masses. |
The study population consists of 7 males and 5 females, age ranging from 51 to 82 years (mean age, 65.8±8.4). Main clinical and pathologic data are reported in Table 1. Mass location was the right atrium (n=2), left atrium (n=2), left and right atrium (n=1), left ventricle (n=4), and right ventricle (n=1); two masses were at the valve level (mitral valve chordae and aortic valve plus fibrous mitroaortic continuity, each). |
2 |
| 92. Wang X, Li Y, Ren W, Yu X, Tan X. Clinical diagnostic value of contrast-enhanced ultrasonography in the diagnosis of cardiac masses: A pilot study. Echocardiography. 2020 Feb;37(2):231-238. |
Observational-Dx |
28 |
To assess the qualitative and quantitative characteristics of suspected cardiac masses by contrast-enhanced ultrasonography (CEUS) and to evaluate its usefulness. |
The benign lesions showed regular morphology and clear-boundary uniform enhancement of the contrast agent. Malignant lesions showed an irregular shape, unclear boundary with surrounding tissue, and uneven enhancement of the contrast agent. The normal myocardial perfusion intensity was the same; there was no enhancement inside a simple thrombus, and the A1 of the benign lesion was lower than that of the normal myocardium (mean value [dB] ± SD, 0.63 ± 0.42); the A2 of the malignant lesion was higher than that of the normal myocardium (mean value [dB] ± SD, 1.49 ± 0.09). The difference in the ratio of A1 to A2 between groups was statistically significant (P < .05). |
1 |
| 93. Uenishi EK, Caldas MA, Tsutsui JM, et al. Evaluation of cardiac masses by real-time perfusion imaging echocardiography. Cardiovasc Ultrasound. 2015 May 02;13():23. |
Observational-Dx |
86 |
We prospectively studied 86 patients, 23 with malignant tumors (MT), 26 with benign tumors (BT), 33 with thrombi and 6 with pseudotumors who underwent RTPE. Mass perfusion was analyzed qualitatively and blood flow volume (A), blood flow velocity (ß), and microvascular blood flow (A x ß) were determined by quantitative RTPE. |
Logistic regression models showed that the probability of having a tumor increased by 15.8 times with a peripheral qualitative perfusion pattern, and 34.5 times with a central perfusion pattern, in comparison with the absence of perfusion. Using quantitative RTPE analysis, thrombi group had parameters of blood flow lower than tumor group. A values for thrombi, MT, and BT were 0.1 dB (0.01-0.22), 2.78 dB (1-7) and 2.58 dB (1.44-5), respectively; p < 0.05, while A x ß values were 0.0 dB/s(-1) (0.01-0.14), 2.00 dB/s(-1) (1-6), and 1.18 dB/s(-1) (0.52-3), respectively; p < 0.05. At peak dipyridamole stress, MT had greater microvascular blood volume than BT [A = 4.18 dB (2.14-7.93) versus A = 2.04 dB (1.09-3.55); p < 0.05], but no difference in blood flow [Axß = 2.46 dB/s(-1) (1.42-4.59) versus Axß = 1.55 dB/s [1] (0.51-4.08); p = NS]. An A value >3.28 dB at peak dipyridamole stress predicted MT (AUC = 0.75) and conferred 5.8-times higher chance of being MT rather than BT. |
1 |
| 94. Guo Y, Wang Y, Kong D, Shu X. Automatic classification of intracardiac tumor and thrombi in echocardiography based on sparse representation. IEEE J Biomed Health Inform. 2015 Mar;19(2):601-11. |
Review/Other-Dx |
97 echocardiograms |
To classify intracardiac tumors and thrombi in echocardiography, potentially to assist the cardiologists in the clinical practice. |
No results stated in abstract. |
4 |
| 95. Parihar AS, Dehdashti F, Wahl RL. FDG PET/CT-based Response Assessment in Malignancies. Radiographics. 2023 Apr;43(4):e220122. |
Review/Other-Dx |
N/A |
To segregate patients who are likely to experience improved survival from those who are not. |
No results stated in abstract. |
4 |
| 96. Bergquist PJ, Chung MS, Jones A, Ahlman MA, White CS, Jeudy J. Cardiac Applications of PET-MR. Curr Cardiol Rep. 2017 May;19(5):42. |
Review/Other-Dx |
N/A |
To provide an overview of the clinical applications of PET-MR in the setting of cardiac imaging with emphasis on specific scenarios where both techniques together provided added information. |
No results stated in abstract. |
4 |
| 97. Measuring Sex, Gender Identity, and Sexual Orientation. |
Review/Other-Dx |
N/A |
Sex and gender are often conflated under the assumptions that they are mutually determined and do not differ from each other; however, the growing visibility of transgender and intersex populations, as well as efforts to improve the measurement of sex and gender across many scientific fields, has demonstrated the need to reconsider how sex, gender, and the relationship between them are conceptualized. |
No abstract available. |
4 |
| 98. American College of Radiology. ACR Appropriateness Criteria® Radiation Dose Assessment Introduction. Available at: https://edge.sitecorecloud.io/americancoldf5f-acrorgf92a-productioncb02-3650/media/ACR/Files/Clinical/Appropriateness-Criteria/ACR-Appropriateness-Criteria-Radiation-Dose-Assessment-Introduction.pdf. |
Review/Other-Dx |
N/A |
To provide evidence-based guidelines on exposure of patients to ionizing radiation. |
No abstract available. |
4 |
