Imaging of Cardiac Tumors and Masses

Abstract

Objective: As noninvasive imaging is gaining widespread acceptance, the aim of the present study was to review our experience with the use of cross sectional imaging modalities to evaluate cardiac tumors and masses.

 Background: Proper diagnosis of the type and extension of a cardiac tumor or mass is very important for therapy planning. Echocardiography has an established role as a non-invasive diagnostic imaging modality. Computed tomography (CT) and magnetic resonance imaging (MRI) also provide adequate delineation of cardiac tumors and masses.

 Methods: Twenty-two patients referred to our department with a suspected cardiac mass, previously detected by cardiac ultrasound, were evaluated by CT (12 patients) and MRI (4 patients). Six patients were examined by both modalities. In 2 cases of staging of a known primary neoplasm and one case of a suspected epicardiac lesion, positron emission tomography (PET-CT) was performed. The CT cardiac examinations were performed using a 16-slice multislice scanner with ECG gating. The MRI examination was performed on a 1.5 Tesla MRI scanner using an ECG-gated cardiac protocol and the PET-CT examination was performed on an integrated PET-CT four-slice scanner, using 370 mMBq of fluorodeoxyglucose. 

 Results: Twenty-two cardiac masses were successfully detected and their characteristics adequately delineated, including eight myxomas, one angiosarcoma, one ventricular lymphoma, one endocardiac metastasis, one epicardiac paraganglioma, and 10 cases of intracardiac thrombi.

 Conclusion: CT and MRI are noninvasive imaging modalities which can delineate cardiac tumors and masses and provide essential information for adequate diagnosis, staging and treatment planning. Compared to cardiac ultrasound, CT and MRI are superior in preoperative planning.

Key words: cardiac tumors,  cross sectional imaging modalities, computed tomography, magnetic resonance imaging