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Maximizing Information From Routine Staging Computed Tomography in Functional Neuroendocrine Neoplasms: Are There Findings Indicating the Presence of Carcinoid Heart Disease?
- Source :
-
Journal of computer assisted tomography [J Comput Assist Tomogr] 2016 Mar-Apr; Vol. 40 (2), pp. 277-82. - Publication Year :
- 2016
-
Abstract
- Purpose: The aim of this study was to evaluate signs of right-sided heart dysfunction on staging computed tomography (CT) as indirect indicators of carcinoid heart disease.<br />Patients and Methods: Patients with functionally active neuroendocrine neoplasm and different grades of tricuspid valve regurgitation (TR) were identified. Two readers independently reviewed contrast-enhanced staging CT performed within 90 days before or after echocardiography. Logistic regression and receiver operating analyses were used to asses the predictive value of right ventricle-left ventricle ratio (RV-LV ratio), ventricular septal bowing, retrograde contrast filling of the hepatic veins during contrast injection, and time to aortal enhancement greater than 100 Hounsfield units during bolus tracking for TR.<br />Results: Forty-four examinations were evaluated (11 with TR = 0, 16 with TR = 1, 9 with TR = 2, and 8 with TR = 3). Right ventricle-LV ratio was found to predict TR less than or equal to 1 versus TR greater than 1 (P = 0.0188) and TR less than or equal to 1 versus TR equals 2 (P = 0.0082). A prolonged time to aortal enhancement greater than 100 Hounsfield units during bolus tracking predicted TR less than or equal to 1 versus TR greater than 1 (P = 0.0077). Area under the curve for RV-LV ratio was 0.86 when differentiating TR less than or equal to 1 versus TR equals 2. With a cutoff of 1.07, sensitivity was 0.89, and specificity was 0.72.<br />Conclusions: In patients with functionally active neuroendocrine neoplasm, an RV-LV ratio of more than 1.07 predicted TR with a relatively high sensitivity and moderate specificity and thus could serve as an indicator of subclinical carcinoid heart disease on routine staging CT.
- Subjects :
- Adult
Aged
Aged, 80 and over
Carcinoid Heart Disease complications
Contrast Media
Female
Heart Ventricles diagnostic imaging
Heart Ventricles pathology
Humans
Male
Middle Aged
Neoplasm Staging
Neuroendocrine Tumors complications
Observer Variation
Radiographic Image Enhancement
Retrospective Studies
Sensitivity and Specificity
Ventricular Dysfunction, Right complications
Ventricular Dysfunction, Right diagnostic imaging
Ventricular Dysfunction, Right pathology
Carcinoid Heart Disease diagnostic imaging
Carcinoid Heart Disease pathology
Neuroendocrine Tumors diagnostic imaging
Neuroendocrine Tumors pathology
Tomography, X-Ray Computed
Subjects
Details
- Language :
- English
- ISSN :
- 1532-3145
- Volume :
- 40
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of computer assisted tomography
- Publication Type :
- Academic Journal
- Accession number :
- 26760186
- Full Text :
- https://doi.org/10.1097/RCT.0000000000000354