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Role of 18F-FDG PET/CT imaging in cardiac and pericardial masses

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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

Considering the few reported cardiac masses, PET/CT in the imaging workup of cardiac masses is not well established. This retrospective study analyzed the role of 18F-FDG PET/CT imaging in cardiac/pericardial masses.

Methods and results

Fifty-nine patients with newly diagnosed cardiac/pericardial masses who underwent PET/CT and transthoracic echocardiography (TTE) were recruited. Echocardiographic and PET/CT characteristics were evaluated for predictive value in differentiating malignant and non-malignant lesions using histologic confirmation as the gold standard. 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.

Conclusions

PET/CT was an effective additional image modality in patients with suspected malignant cardiac mass for further confirmation and to screen for potential metastasis.

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Abbreviations

TTE:

Transthoracic echocardiography

SUVmax:

Maximum standardized uptake value

TMR:

Tumor-to-mediastinum tissue ratio

AUC:

Area under the curve

ROC:

Receiver-operating-characteristic

PET:

Positron emission tomography

CT:

Computed tomography

18F-FDG:

18F-Fluorodeoxyglucose

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Acknowledgments

Supported by: Hongyan Yin was sponsored by a Young Scholar Grant from the National Natural Science Foundation of China (81501500) and Hongcheng Shi was supported by Shanghai Municipal Key Clinical Specialty (shslczdzk03401).

Disclosure

Hongyan Yin, Wujian Mao, Hui Tan, Na Zhu, Quan Wan, Jing Shi, Lin Qiu, Yan Xiu, Rongkui Luo, Haojun Yu, Hongcheng Shi have nothing to declare. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

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Author notes

  1. Hongyan Yin, Wujian Mao, and Hui Tan contributed equally to this paper.

Authors and Affiliations

  1. Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Rd, Shanghai, 200032, China

    Hongyan Yin MD, Wujian Mao MD, Hui Tan PhD, Lin Qiu MD, Yan Xiu PhD, Haojun Yu BS & Hongcheng Shi PhD

  2. Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China

    Na Zhu MD & Rongkui Luo MD

  3. Department of Echocardiology, Zhongshan Hospital, Fudan University, Shanghai, China

    Quan Wan MD & Jing Shi MD, PhD

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  1. Hongyan Yin MD
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Hongyan Yin was sponsored by a Young Scholar Grant from the National Natural Science Foundation of China (81501500) and Hongcheng Shi was supported by Shanghai Municipal Key Clinical Specialty (shslczdzk03401).

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Yin, H., Mao, W., Tan, H. et al. Role of 18F-FDG PET/CT imaging in cardiac and pericardial masses. J. Nucl. Cardiol. 29, 1293–1303 (2022). https://doi.org/10.1007/s12350-020-02510-9

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  • DOI: https://doi.org/10.1007/s12350-020-02510-9

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