Chetan Shenoy1, John D Grizzard2, Dipan J Shah3, Mahwash Kassi3, Michael J Reardon3, Marianna Zagurovskaya2, Han W Kim4, Michele A Parker4, Raymond J Kim4. 1. University of Minnesota Medical Center, Cardiovascular Division, Department of Medicine, 420 Delaware St MMC 508, Minneapolis, MN, USA. 2. Virginia Commonwealth University Medical Center, 1250 E. Marshall Street, Richmond, VA, USA. 3. Houston Methodist Hospital, 6550 Fannin St Suite 1901, Houston, TX, USA. 4. Duke University Medical Center, Duke Medical Pavilion, 10 Medicine Circle, Rm IE-58 Durham, NC 27710, USA.
Abstract
AIMS: 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. METHODS AND RESULTS: 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). CONCLUSION: In patients with suspected cardiac tumour, CMR has high diagnostic accuracy. Patients with CMR diagnoses of no mass, pseudomass, and benign tumour have similar long-term mortality. The CMR diagnosis is a powerful independent predictor of mortality incremental to clinical risk factors. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: 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. METHODS AND RESULTS: 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). CONCLUSION: In patients with suspected cardiac tumour, CMR has high diagnostic accuracy. Patients with CMR diagnoses of no mass, pseudomass, and benign tumour have similar long-term mortality. The CMR diagnosis is a powerful independent predictor of mortality incremental to clinical risk factors. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Pratik S Velangi; Christopher Choo; Ko-Hsuan A Chen; Felipe Kazmirczak; Prabhjot S Nijjar; Afshin Farzaneh-Far; Osama Okasha; Mehmet Akçakaya; Jonathan W Weinsaft; Chetan Shenoy Journal: Circ Cardiovasc Imaging Date: 2019-11-11 Impact factor: 7.792
Authors: Pablo Pazos-López; Eduardo Pozo; Maria E Siqueira; Inés García-Lunar; Matthew Cham; Adam Jacobi; Frank Macaluso; Valentín Fuster; Jagat Narula; Javier Sanz Journal: JACC Cardiovasc Imaging Date: 2014-08-13
Authors: John F Heitner; Raymond J Kim; Han W Kim; Igor Klem; Dipan J Shah; Dany Debs; Afshin Farzaneh-Far; Venkateshwar Polsani; Jiwon Kim; Jonathan Weinsaft; Chetan Shenoy; Andrew Hughes; Preston Cargile; Jean Ho; Robert O Bonow; Elizabeth Jenista; Michele Parker; Robert M Judd Journal: JAMA Cardiol Date: 2019-03-01 Impact factor: 14.676
Authors: Ibrahim Sultan; Valentino Bianco; Andreas Habertheuer; Arman Kilic; Thomas G Gleason; Edgar Aranda-Michel; Matthew E Harinstein; Deirdre Martinez-Meehan; George Arnaoutakis; Olugbenga Okusanya Journal: J Am Coll Cardiol Date: 2020-05-12 Impact factor: 24.094
Authors: Negareh Mousavi; Michael K Cheezum; Ayaz Aghayev; Robert Padera; Tomas Vita; Michael Steigner; Edward Hulten; Marcio Sommer Bittencourt; Sharmila Dorbala; Marcelo F Di Carli; Raymond Y Kwong; Ruth Dunne; Ron Blankstein Journal: J Am Heart Assoc Date: 2019-01-08 Impact factor: 5.501
Authors: Christopher M Kramer; Jorg Barkhausen; Scott D Flamm; Raymond J Kim; Eike Nagel Journal: J Cardiovasc Magn Reson Date: 2008-07-07 Impact factor: 5.364
Authors: Vineeta Ojha; Omar K Khalique; Rishabh Khurana; Daniel Lorenzatti; Steve W Leung; Benny Lawton; Timothy C Slesnick; Joao C Cavalcante; Chiara-Bucciarelli Ducci; Amit R Patel; Claudia C Prieto; Sven Plein; Subha V Raman; Michael Salerno; Purvi Parwani Journal: J Cardiovasc Magn Reson Date: 2022-06-20 Impact factor: 6.903