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Diagnostic Accuracy of Cardiac Computed Tomography and 18F-Fluorodeoxyglucose With Positron Emission Tomography in Cardiac Masses.

Authors :
D'Angelo, Emanuela Concetta
Paolisso, Pasquale
Vitale, Giovanni
Foà, Alberto
Bergamaschi, Luca
Magnani, Ilenia
Saturi, Giulia
Rinaldi, Andrea
Toniolo, Sebastiano
Renzulli, Matteo
Attinà, Domenico
Lovato, Luigi
Lima, Giacomo Maria
Bonfiglioli, Rachele
Fanti, Stefano
Leone, Ornella
Saponara, Maristella
Pantaleo, Maria Abbondanza
Rucci, Paola
Di Marco, Luca
Source :
JACC: Cardiovascular Imaging; Nov2020, Vol. 13 Issue 11, p2400-2411, 12p
Publication Year :
2020

Abstract

This study sought to assess the diagnostic accuracy of cardiac computed tomography (CT) and <superscript>18</superscript>F-fluorodeoxyglucose (<superscript>18</superscript>F-FDG) with positron emission tomography/computed tomography (PET/CT) in defining the nature of cardiac masses. The diagnostic accuracy of cardiac CT and <superscript>18</superscript>F-FDG PET/CT in identifying the nature of cardiac masses has been analyzed to date only in small samples. Of 223 patients with echocardiographically diagnosed cardiac masses, a cohort of 60 cases who underwent cardiac CT and <superscript>18</superscript>F-FDG PET/CT was selected. All masses had histological confirmation, except for a minority of thrombotic formations. For each mass, 8 morphological CT signs, standardized uptake value (SUV max , SUV mean), metabolic tumor volume, and total lesion glycolysis in <superscript>18</superscript>F-FDG PET were used as diagnostic markers. Irregular tumor margins, pericardial effusion, invasion, solid nature, mass diameter, CT contrast uptake, and pre-contrast 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 SUV max , SUV mean , 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 <superscript>18</superscript>F-FDG 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 <superscript>18</superscript>F-FDG PET/CT parameter significantly increased the identification of malignancies. Cardiac CT is a powerful tool to diagnose cardiac masses as the number of abnormal signs was found to correlate with the lesions' nature. Similarly, <superscript>18</superscript>F-FDG PET/CT accurately identified malignant masses and contributed with additional valuable information in diagnostic uncertainties after cardiac CT. These imaging tools should be performed in specific clinical settings such as involvement of great vessels or for disease-staging purposes. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
1936878X
Volume :
13
Issue :
11
Database :
Supplemental Index
Journal :
JACC: Cardiovascular Imaging
Publication Type :
Academic Journal
Accession number :
146615587
Full Text :
https://doi.org/10.1016/j.jcmg.2020.03.021