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Tagliati C, Fogante M, Palmisano A, Catapano F, Lisi C, Monti L, Lanni G, Cerimele F, Bernardini A, Procaccini L, Argalia G, Esposto Pirani P, Marcucci M, Rebonato A, Cerimele C, Luciano A, Cesarotto M, Belgrano M, Pagnan L, Sarno A, Cova MA, Ventura F, Regnicolo L, Polonara G, Uguccioni L, Quaranta A, Balardi L, Barbarossa A, Stronati G, Guerra F, Chiocchi M, Francone M, Esposito A, Schicchi N. Cardiac Masses and Pseudomasses: An Overview about Diagnostic Imaging and Clinical Background. MEDICINA (KAUNAS, LITHUANIA) 2023; 60:70. [PMID: 38256331 PMCID: PMC10818366 DOI: 10.3390/medicina60010070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/09/2023] [Accepted: 12/26/2023] [Indexed: 01/24/2024]
Abstract
A cardiac lesion detected at ultrasonography might turn out to be a normal structure, a benign tumor or rarely a malignancy, and lesion characterization is very important to appropriately manage the lesion itself. The exact relationship of the mass with coronary arteries and the knowledge of possible concomitant coronary artery disease are necessary preoperative information. Moreover, the increasingly performed coronary CT angiography to evaluate non-invasively coronary artery disease leads to a rising number of incidental findings. Therefore, CT and MRI are frequently performed imaging modalities when echocardiography is deemed insufficient to evaluate a lesion. A brief comprehensive overview about diagnostic radiological imaging and the clinical background of cardiac masses and pseudomasses is reported.
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Affiliation(s)
- Corrado Tagliati
- Radiologia, AST Pesaro Urbino, 61121 Pesaro, Italy; (C.T.); (A.R.)
| | - Marco Fogante
- Maternal-Child, Senological, Cardiological Radiology and Outpatient Ultrasound, Department of Radiological Sciences, University Hospital of Marche, 60126 Ancona, Italy; (G.A.); (P.E.P.)
| | - Anna Palmisano
- Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy; (A.P.); (A.E.)
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy
| | - Federica Catapano
- Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini 4, 20072 Milan, Italy; (F.C.); (C.L.); (L.M.); (M.F.)
- IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Costanza Lisi
- Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini 4, 20072 Milan, Italy; (F.C.); (C.L.); (L.M.); (M.F.)
| | - Lorenzo Monti
- Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini 4, 20072 Milan, Italy; (F.C.); (C.L.); (L.M.); (M.F.)
- IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Giuseppe Lanni
- Radiologia, ASL 4 Teramo, 64100 Teramo, Italy; (G.L.); (F.C.); (A.B.); (L.P.)
| | - Federico Cerimele
- Radiologia, ASL 4 Teramo, 64100 Teramo, Italy; (G.L.); (F.C.); (A.B.); (L.P.)
| | - Antonio Bernardini
- Radiologia, ASL 4 Teramo, 64100 Teramo, Italy; (G.L.); (F.C.); (A.B.); (L.P.)
| | - Luca Procaccini
- Radiologia, ASL 4 Teramo, 64100 Teramo, Italy; (G.L.); (F.C.); (A.B.); (L.P.)
| | - Giulio Argalia
- Maternal-Child, Senological, Cardiological Radiology and Outpatient Ultrasound, Department of Radiological Sciences, University Hospital of Marche, 60126 Ancona, Italy; (G.A.); (P.E.P.)
| | - Paolo Esposto Pirani
- Maternal-Child, Senological, Cardiological Radiology and Outpatient Ultrasound, Department of Radiological Sciences, University Hospital of Marche, 60126 Ancona, Italy; (G.A.); (P.E.P.)
| | - Matteo Marcucci
- U.O.C. di Radiodiagnostica, Ospedale Generale Provinciale di Macerata, 62100 Macerata, Italy;
| | - Alberto Rebonato
- Radiologia, AST Pesaro Urbino, 61121 Pesaro, Italy; (C.T.); (A.R.)
| | - Cecilia Cerimele
- Dipartimento di Biomedicina e Prevenzione, Universiy of Roma Tor Vergata, 00133 Roma, Italy; (C.C.); (A.L.); (M.C.)
| | - Alessandra Luciano
- Dipartimento di Biomedicina e Prevenzione, Universiy of Roma Tor Vergata, 00133 Roma, Italy; (C.C.); (A.L.); (M.C.)
| | - Matteo Cesarotto
- Department of Radiology, Azienda Sanitaria Universitaria Giuliano Isontina Ospedale di Cattinara, 34149 Trieste, Italy; (M.C.); (L.P.); (A.S.)
| | - Manuel Belgrano
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34151 Trieste, Italy; (M.B.); (M.A.C.)
| | - Lorenzo Pagnan
- Department of Radiology, Azienda Sanitaria Universitaria Giuliano Isontina Ospedale di Cattinara, 34149 Trieste, Italy; (M.C.); (L.P.); (A.S.)
| | - Alessandro Sarno
- Department of Radiology, Azienda Sanitaria Universitaria Giuliano Isontina Ospedale di Cattinara, 34149 Trieste, Italy; (M.C.); (L.P.); (A.S.)
| | - Maria Assunta Cova
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34151 Trieste, Italy; (M.B.); (M.A.C.)
| | | | - Luana Regnicolo
- Department of Neuroradiology, University Hospital of Marche, 60126 Ancona, Italy;
| | - Gabriele Polonara
- Department of Specialized Clinical Sciences and Odontostomatology, Polytechnic University of Marche, 60126 Ancona, Italy;
| | - Lucia Uguccioni
- Emodinamica e Cardiologia Interventistica, AST Pesaro Urbino, 61121 Pesaro, Italy;
| | - Alessia Quaranta
- Cardiologia, Distretto Sanitario di Civitanova Marche, AST 3, 62012 Civitanova Marche, Italy;
| | - Liliana Balardi
- Health Professions Area, Diagnostic Technical Area, University Hospital of Marche, 60126 Ancona, Italy;
| | - Alessandro Barbarossa
- Cardiology and Arrhythmology Clinic, Department of Cardiological Sciences, University Hospital of Marche, 60126 Ancona, Italy; (A.B.); (G.S.); (F.G.)
| | - Giulia Stronati
- Cardiology and Arrhythmology Clinic, Department of Cardiological Sciences, University Hospital of Marche, 60126 Ancona, Italy; (A.B.); (G.S.); (F.G.)
| | - Federico Guerra
- Cardiology and Arrhythmology Clinic, Department of Cardiological Sciences, University Hospital of Marche, 60126 Ancona, Italy; (A.B.); (G.S.); (F.G.)
| | - Marcello Chiocchi
- Dipartimento di Biomedicina e Prevenzione, Universiy of Roma Tor Vergata, 00133 Roma, Italy; (C.C.); (A.L.); (M.C.)
| | - Marco Francone
- Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini 4, 20072 Milan, Italy; (F.C.); (C.L.); (L.M.); (M.F.)
- IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Antonio Esposito
- Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy; (A.P.); (A.E.)
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy
| | - Nicolò Schicchi
- Cardiovascular Radiological Diagnostics, Department of Radiological Sciences, University Hospital of Marche, 60126 Ancona, Italy;
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2
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Schottstaedt AM, Paulson ES, Rubenstein JC, Chen X, Omari EA, Li XA, Schultz CJ, Puckett LL, Robinson CG, Alongi F, Gore EM, Hall WA. Development of a comprehensive cardiac atlas on a 1.5 Tesla Magnetic Resonance Linear Accelerator. Phys Imaging Radiat Oncol 2023; 28:100504. [PMID: 38035207 PMCID: PMC10682663 DOI: 10.1016/j.phro.2023.100504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 10/18/2023] [Accepted: 10/30/2023] [Indexed: 12/02/2023] Open
Abstract
Background and purpose The 1.5 Tesla (T) Magnetic Resonance Linear Accelerator (MRL) provides an innovative modality for improved cardiac imaging when planning radiation treatment. No MRL based cardiac atlases currently exist, thus, we sought to comprehensively characterize cardiac substructures, including the conduction system, from cardiac images acquired using a 1.5 T MRL and provide contouring guidelines. Materials and methods Five volunteers were enrolled in a prospective protocol (NCT03500081) and were imaged on the 1.5 T MRL with Half Fourier Single-Shot Turbo Spin-Echo (HASTE) and 3D Balanced Steady-State Free Precession (bSSFP) sequences in axial, short axis, and vertical long axis. Cardiac anatomy was contoured by (AS) and confirmed by a board certified cardiologist (JR) with expertise in cardiac MR imaging. Results A total of five volunteers had images acquired with the HASTE sequence, with 21 contours created on each image. One of these volunteers had additional images obtained with 3D bSSFP sequences in the axial plane and additional images obtained with HASTE sequences in the key cardiac planes. Contouring guidelines were created and outlined. 15-16 contours were made for the short axis and vertical long axis. The cardiac conduction system was demonstrated with eleven representative contours. There was reasonable variation of contour volume across volunteers, with structures more clearly delineated on the 3D bSSFP sequence. Conclusions We present a comprehensive cardiac atlas using novel images acquired prospectively on a 1.5 T MRL. This cardiac atlas provides a novel resource for radiation oncologists in delineating cardiac structures for treatment with radiotherapy, with special focus on the cardiac conduction system.
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Affiliation(s)
- Aronne M. Schottstaedt
- Medical College of Wisconsin, Department of Radiation Oncology, Milwaukee, WI, United States
| | - Eric S. Paulson
- Medical College of Wisconsin, Department of Radiation Oncology, Milwaukee, WI, United States
- Medical College of Wisconsin, Department of Radiology, Milwaukee, WI, United States
| | - Jason C. Rubenstein
- Medical College of Wisconsin, Department of Radiology, Milwaukee, WI, United States
- Medical College of Wisconsin, Department of Cardiology, Milwaukee, WI, United States
| | - Xinfeng Chen
- Medical College of Wisconsin, Department of Radiation Oncology, Milwaukee, WI, United States
| | - Eenas A. Omari
- Medical College of Wisconsin, Department of Radiation Oncology, Milwaukee, WI, United States
| | - X Allen Li
- Medical College of Wisconsin, Department of Radiation Oncology, Milwaukee, WI, United States
| | - Chris J. Schultz
- Medical College of Wisconsin, Department of Radiation Oncology, Milwaukee, WI, United States
| | - Lindsay L. Puckett
- Medical College of Wisconsin, Department of Radiation Oncology, Milwaukee, WI, United States
| | - Clifford G. Robinson
- Washington University, Department of Radiation Oncology, St. Louis, MO, United States
| | - Filippo Alongi
- IRCCS Sacro Cuore Don Calabria Hospital, Department of Radiation Oncology, Negrar-Verona, Italy & University of Brescia, Faculty of Medicine, Brescia, Italy
| | - Elizabeth M. Gore
- Medical College of Wisconsin, Department of Radiation Oncology, Milwaukee, WI, United States
| | - William A. Hall
- Medical College of Wisconsin, Department of Radiation Oncology, Milwaukee, WI, United States
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3
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Meir J, Michaud L, Frishman WH, Aronow WS. The Past, Present, and The Future of Carcinoid Heart Disease. Cardiol Rev 2023; 31:193-198. [PMID: 36515580 DOI: 10.1097/crd.0000000000000475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Carcinoid heart disease is a frequent manifestation of carcinoid syndrome. It results from the release of a large amount of serotonin and subsequently fibrosis of right sided heart valves, that is, tricuspid and pulmonic valve. This article reviews the pathogenesis, clinical symptoms, diagnosis, treatment and prognosis of carcinoid heart disease. Recent developments in treating carcinoid heart disease have improved the poor prognosis associated with the disease.
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Affiliation(s)
- Juliet Meir
- From the Departments of Cardiology and Medicine, Westchester Medical Center and New York Medical College, Vaslhalla, NY
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Grazzini G, Pradella S, Rossi A, Basile RP, Ruggieri M, Galli D, Palmisano A, Palumbo P, Esposito A, Miele V. Practical Guide to Interpreting Cardiac Magnetic Resonance in Patients with Cardiac Masses. J Cardiovasc Dev Dis 2023; 10:229. [PMID: 37367394 DOI: 10.3390/jcdd10060229] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/17/2023] [Accepted: 05/22/2023] [Indexed: 06/28/2023] Open
Abstract
It is common for a cardiac mass to be discovered accidentally during an echocardiographic examination. Following the relief of a cardiac mass, being able to evaluate and characterize it using non-invasive imaging methods is critical. Echocardiography, computed tomography (CT), cardiac magnetic resonance imaging (CMR), and positron emission tomography (PET) are the main imaging modalities used to evaluate cardiac masses. Although multimodal imaging often allows for a better assessment, CMR is the best technique for the non-invasive characterization of tissues, as the different MR sequences help in the diagnosis of cardiac masses. This article provides detailed descriptions of each CMR sequence employed in the evaluation of cardiac masses, underlining the potential information it can provide. The description in the individual sequences provides useful guidance to the radiologist in performing the examination.
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Affiliation(s)
- Giulia Grazzini
- Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50134 Florence, Italy
| | - Silvia Pradella
- Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50134 Florence, Italy
| | - Alice Rossi
- Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50134 Florence, Italy
| | - Rocco Pio Basile
- Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50134 Florence, Italy
| | - Matteo Ruggieri
- Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50134 Florence, Italy
| | - Daniele Galli
- Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50134 Florence, Italy
| | - Anna Palmisano
- Experimental Imaging Center, San Raffaele Scientific Institute, Via Olgettina 60, 20100 Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy
| | - Pierpaolo Palumbo
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio 1, 67100 L'Aquila, Italy
| | - Antonio Esposito
- Experimental Imaging Center, San Raffaele Scientific Institute, Via Olgettina 60, 20100 Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy
| | - Vittorio Miele
- Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50134 Florence, Italy
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5
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Ohte N, Ishizu T, Izumi C, Itoh H, Iwanaga S, Okura H, Otsuji Y, Sakata Y, Shibata T, Shinke T, Seo Y, Daimon M, Takeuchi M, Tanabe K, Nakatani S, Nii M, Nishigami K, Hozumi T, Yasukochi S, Yamada H, Yamamoto K, Izumo M, Inoue K, Iwano H, Okada A, Kataoka A, Kaji S, Kusunose K, Goda A, Takeda Y, Tanaka H, Dohi K, Hamaguchi H, Fukuta H, Yamada S, Watanabe N, Akaishi M, Akasaka T, Kimura T, Kosuge M, Masuyama T. JCS 2021 Guideline on the Clinical Application of Echocardiography. Circ J 2022; 86:2045-2119. [DOI: 10.1253/circj.cj-22-0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Nobuyuki Ohte
- Department of Cardiology, Nagoya City University Graduate School of Medical Sciences
| | | | - Chisato Izumi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Hiroshi Itoh
- Department of Cardiovascular Medicine, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Science
| | - Shiro Iwanaga
- Department of Cardiology, Saitama Medical University International Medical Center
| | - Hiroyuki Okura
- Department of Cardiology, Gifu University Graduate School of Medicine
| | | | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | - Toshihiko Shibata
- Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine
| | - Toshiro Shinke
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Yoshihiro Seo
- Department of Cardiology, Nagoya City University Graduate School of Medical Sciences
| | - Masao Daimon
- The Department of Clinical Laboratory, The University of Tokyo Hospital
| | - Masaaki Takeuchi
- Department of Laboratory and Transfusion Medicine, Hospital of University of Occupational and Environmental Health
| | - Kazuaki Tanabe
- The Fourth Department of Internal Medicine, Shimane University Faculty of Medicine
| | | | - Masaki Nii
- Department of Cardiology, Shizuoka Children's Hospital
| | - Kazuhiro Nishigami
- Division of Cardiovascular Medicine, Miyuki Hospital LTAC Heart Failure Center
| | - Takeshi Hozumi
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Satoshi Yasukochi
- Department of Pediatric Cardiology, Heart Center, Nagano Children’s Hospital
| | - Hirotsugu Yamada
- Department of Community Medicine for Cardiology, Tokushima University Graduate School of Biomedical Sciences
| | - Kazuhiro Yamamoto
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of Medicine, Tottori University
| | - Masaki Izumo
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine
| | - Katsuji Inoue
- Department of Cardiology, Pulmonology, Hypertension & Nephrology, Ehime University Graduate School of Medicine
| | | | - Atsushi Okada
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | | | - Shuichiro Kaji
- Department of Cardiovascular Medicine, Kansai Electric Power Hospital
| | - Kenya Kusunose
- Department of Cardiovascular Medicine, Tokushima University Hospital
| | - Akiko Goda
- Department of Cardiovascular and Renal Medicine, Hyogo College of Medicine
| | - Yasuharu Takeda
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | - Hidekazu Tanaka
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Kaoru Dohi
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine
| | | | - Hidekatsu Fukuta
- Core Laboratory, Nagoya City University Graduate School of Medical Sciences
| | - Satoshi Yamada
- Department of Cardiology, Tokyo Medical University Hachioji Medical Center
| | - Nozomi Watanabe
- Department of Cardiology, Miyazaki Medical Association Hospital Cardiovascular Center
| | | | - Takashi Akasaka
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Takeshi Kimura
- Department of Cardiology, Kyoto University Graduate School of Medicine
| | - Masami Kosuge
- Division of Cardiology, Yokohama City University Medical Center
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El Ghannudi S, Ouvrard E, Mikail N, Leroy Freschini B, Schindler TH, Imperiale A. Cutting-Edge Imaging of Cardiac Metastases from Neuroendocrine Tumors: Lesson from a Case Series. Diagnostics (Basel) 2022; 12:diagnostics12051182. [PMID: 35626337 PMCID: PMC9139778 DOI: 10.3390/diagnostics12051182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/05/2022] [Accepted: 05/07/2022] [Indexed: 11/16/2022] Open
Abstract
With the increasing availability of high-performance medical imaging for the management of patients with neuroendocrine tumors (NETs), a progressive growth of asymptomatic and incidentally detected cardiac metastases (CMs) has been observed in the recent years. In clinical practice, CMs of NENs are often incidentally detected by whole-body 68Ga-labeled somatostatin analogs or 18F-fluorodihydroxyphenylalanine positron emission tomography/computed tomography, and afterwards accurately characterized by cardiac magnetic resonance (CMR) and/or gated cardiac computed tomography when CMR is contraindicated or not available. The interpreting physician should familiarize with the main imaging features of CM, a finding that may be encountered in NETs patients more than previously thought. Herein, we present a case series of four patients with CMs from small-intestine NETs highlighting strengths and weaknesses of a multimodality imaging approach in clinical practice.
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Affiliation(s)
- Soraya El Ghannudi
- Nuclear Medicine, Institut de Cancérologie de Strasbourg Europe (ICANS), University Hospitals of Strasbourg, 67093 Strasbourg, France; (E.O.); (B.L.F.)
- Department of Radiology, University Hospitals of Strasbourg, 67098 Strasbourg, France
- Correspondence: (S.E.G.); (A.I.)
| | - Eric Ouvrard
- Nuclear Medicine, Institut de Cancérologie de Strasbourg Europe (ICANS), University Hospitals of Strasbourg, 67093 Strasbourg, France; (E.O.); (B.L.F.)
| | - Nidaa Mikail
- Nuclear Medicine, ENETS Centre of Excellence, Beaujon Hospital (APHP), 92110 Clichy, France;
| | - Benjamin Leroy Freschini
- Nuclear Medicine, Institut de Cancérologie de Strasbourg Europe (ICANS), University Hospitals of Strasbourg, 67093 Strasbourg, France; (E.O.); (B.L.F.)
| | - Thomas H. Schindler
- Division of Nuclear Medicine, Mallinckrodt Institute of Radiology, Washington University, St. Louis, MO 63110, USA;
| | - Alessio Imperiale
- Nuclear Medicine, Institut de Cancérologie de Strasbourg Europe (ICANS), University Hospitals of Strasbourg, 67093 Strasbourg, France; (E.O.); (B.L.F.)
- Molecular Imaging—DRHIM, IPHC, UMR 7178, CNRS/Unistra, 67093 Strasbourg, France
- Correspondence: (S.E.G.); (A.I.)
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7
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Carrabba N, Pontone G, Andreini D, Buffa V, Cademartiri F, Carbone I, Clemente A, Guaricci AI, Guglielmo M, Indolfi C, La Grutta L, Ligabue G, Liguori C, Mercuro G, Mushtaq S, Neglia D, Palmisano A, Sciagrà R, Seitun S, Vignale D, Francone M, Esposito A. Appropriateness criteria for the use of cardiac computed tomography, SIC-SIRM part 2: acute chest pain evaluation; stent and coronary artery bypass graft patency evaluation; planning of coronary revascularization and transcatheter valve procedures; cardiomyopathies, electrophysiological applications, cardiac masses, cardio-oncology and pericardial diseases evaluation. J Cardiovasc Med (Hagerstown) 2022; 23:290-303. [PMID: 35486680 DOI: 10.2459/jcm.0000000000001303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
In the past 20 years, cardiac computed tomography (CCT) has become a pivotal technique for the noninvasive diagnostic workup of coronary and cardiac diseases. Continuous technical and methodological improvements, combined with fast growing scientific evidence, have progressively expanded the clinical role of CCT. Randomized clinical trials documented the value of CCT in increasing the cost-effectiveness of the management of patients with acute chest pain presenting in the emergency department, also during the pandemic. Beyond the evaluation of stents and surgical graft patency, the anatomical and functional coronary imaging have the potential to guide treatment decision-making and planning for complex left main and three-vessel coronary disease. Furthermore, there has been an increasing demand to use CCT for preinterventional planning in minimally invasive procedures, such as transcatheter valve implantation and mitral valve repair. Yet, the use of CCT as a roadmap for tailored electrophysiological procedures has gained increasing importance to assure maximum success. In the meantime, innovations and advanced postprocessing tools have generated new potential applications of CCT from the simple coronary anatomy to the complete assessment of structural, functional and pathophysiological biomarkers of cardiac disease. In this complex and revolutionary scenario, it is urgently needed to provide an updated guide for the appropriate use of CCT in different clinical settings. This manuscript, endorsed by the Italian Society of Cardiology (SIC) and the Italian Society of Medical and Interventional Radiology (SIRM), represents the second of two consensus documents collecting the expert opinion of cardiologists and radiologists about current appropriate use of CCT.
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Affiliation(s)
- Nazario Carrabba
- Department of Cardiothoracovascular Medicine, Azienda Ospedaliero-Universitaria Careggi, Florence
| | | | - Daniele Andreini
- Centro Cardiologico Monzino IRCCS.,Department of Clinical Sciences and Community Health, University of Milan, Milan
| | - Vitaliano Buffa
- Department of Radiology, Azienda Ospedaliera San Camillo Forlanini, Rome
| | | | - Iacopo Carbone
- Department of Radiological, Oncological and Pathological Sciences, 'Sapienza' University of Rome, Rome
| | - Alberto Clemente
- Department of Radiology, CNR (National Council of Research)/Tuscany Region 'Gabriele Monasterio' Foundation (FTGM), Massa
| | - Andrea Igoren Guaricci
- University Cardiology Unit, Cardiothoracic Department, Policlinic University Hospital, Bari
| | | | - Ciro Indolfi
- Department of Medical and Surgical Sciences, Magna Grecia University, Catanzaro
| | - Ludovico La Grutta
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties-ProMISE, University of Palermo
| | - Guido Ligabue
- Department of Medical and Surgical Sciences, Modena and Raggio Emilia University.,Radiology Department, AOU of Modena, Modena
| | - Carlo Liguori
- Radiology Unit, Ospedale del Mare -A.S.L Na1- Centro, Naples
| | - Giuseppe Mercuro
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari
| | | | - Danilo Neglia
- Cardiovascular Department, CNR (National Council of Research)/Tuscany Region 'Gabriele Monasterio' Foundation (FTGM), Pisa
| | - Anna Palmisano
- Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS Ospedale San Raffaele.,Vita-Salute San Raffaele University, Milan
| | - Roberto Sciagrà
- Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences 'Mario Serio', University of Florence, Florence
| | - Sara Seitun
- Radiology Department, Ospedale Policlinico San Martino, IRCCS Per L'Oncologia e le Neuroscienze, Genoa, Italy
| | - Davide Vignale
- Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS Ospedale San Raffaele.,Vita-Salute San Raffaele University, Milan
| | - Marco Francone
- Department of Radiological, Oncological and Pathological Sciences, 'Sapienza' University of Rome, Rome
| | - Antonio Esposito
- Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS Ospedale San Raffaele.,Vita-Salute San Raffaele University, Milan
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8
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Diagnosis and staging of cardiac masses: additional value of CMR with 18F-FDG-PET compared to CMR with CECT. Eur J Nucl Med Mol Imaging 2022; 49:2232-2241. [PMID: 35247063 DOI: 10.1007/s00259-022-05709-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 01/25/2022] [Indexed: 11/04/2022]
Abstract
PURPOSE Characterization of malignant cardiac masses is usually performed with cardiac magnetic resonance (CMR) and staging with whole-body contrast-enhanced computed tomography (CECT). In this study, our objective was to evaluate the role of 18Fluor-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) with CMR for both characterization and staging of cardiac masses. METHODS Patients with cardiac masses who underwent CMR, CECT, and 18F-FDG-PET were retrospectively identified. For the characterization of cardiac masses, we calculated the respective performances of CMR alone, 18F-FDG-PET alone, and the combination of 18F-FDG-PET and CMR. For staging, we compared head-to-head the respective performances of 18F-FDG-PET and CECT. Histology served as gold standard for malignancy, and response to anticoagulation for thrombus. RESULTS In a total of 28 patients (median age 60.5 years, 60.7% women), CMR accurately distinguished malignant from benign masses with sensitivity (Se) of 86.7%, specificity (Sp) of 100%, positive predictive value (PPV) of 100%, negative predictive value (NPV) of 86.7%, and accuracy of 92.9%. 18F-FDG-PET demonstrated 93.3% Se, 84.6% Sp, 87.5% PPV, 91.7% NPV, and 89.3% accuracy. Combining CMR with 18F-FDG-PET allowed to benefit from the high sensitivity of 18F-FDG-PET (92.9%) and the excellent specificity of CMR (100%) for malignant diseases. For staging, 18F-FDG-PET outperformed CECT on per-patient (66.7% vs 55.6% correct diagnosis, respectively), per-organ (10 vs 7 organs, respectively), and per-lesion basis (> 29 vs > 25 lesions, respectively). CONCLUSION Combining 18F-FDG-PET with CMR improved the characterization of cardiac masses compared to each modality alone. Additionally, the diagnostic performance of 18F-FDG-PET was better than CECT for staging. This study suggests that the combination of CMR and 18F-FDG-PET is the most effective for the characterization of cardiac masses and the staging of these lesions.
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9
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Matteucci M, Ferrarese S, Mantovani V, Ronco D, Torchio F, Franzosi C, Marazzato J, De Ponti R, Lorusso R, Beghi C. Surgical treatment of primary cardiac tumors in the contemporary era: A single-centre analysis. J Card Surg 2021; 36:3540-3546. [PMID: 34254361 PMCID: PMC8518736 DOI: 10.1111/jocs.15813] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/16/2021] [Accepted: 07/05/2021] [Indexed: 12/18/2022]
Abstract
Background Primary cardiac tumors (PCT) are rare lesions but have the potential to cause significant morbidity if not timely treated. We reviewed our single‐center experience in the surgical treatment of PCT with a focus on the long‐term outcome. Methods From 2001 to 2020, 57 consecutive patients underwent surgical resection of PCT at our Institution. Data including the demographic characteristics, tumor histology, surgical procedure, and postoperative outcomes were collected and analyzed. Results Mean age at presentation was 63.6 ± 11.2 years, and 33 (57.9%) of the patients were female. A total of 55 (96.5%) subjects were diagnosed with benign cardiac tumor, while the remaining had malignant tumors. The most common histopathological type was myxoma. All patients survived to hospital discharge. Main postoperative complications were: acute kidney injury (n = 3), sepsis (n = 3), and stroke (n = 2). Mean follow‐up time was 9 ± 5.9 years. Long‐term mortality was 22.8% (13/57). No tumor recurrence was observed among survivors. There was a significant relationship between mortality and pathological characteristics of the tumor, and myxomas had higher survival rates. Conclusion Surgical treatment of PCT is a safe and highly effective strategy associated with excellent short‐term outcomes. Long‐term survival remains poor for primary malignant tumors of the heart.
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Affiliation(s)
- Matteo Matteucci
- Department of Surgical and Morphological Sciences, Circolo Hospital, University of Insubria, Varese, Italy.,Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Sandro Ferrarese
- Department of Surgical and Morphological Sciences, Circolo Hospital, University of Insubria, Varese, Italy
| | - Vittorio Mantovani
- Department of Surgical and Morphological Sciences, Circolo Hospital, University of Insubria, Varese, Italy
| | - Daniele Ronco
- Department of Surgical and Morphological Sciences, Circolo Hospital, University of Insubria, Varese, Italy
| | - Federica Torchio
- Department of Surgical and Morphological Sciences, Circolo Hospital, University of Insubria, Varese, Italy
| | - Cinzia Franzosi
- Department of Medicine and Surgery, Circolo Hospital, University of Insubria, Varese, Italy
| | - Jacopo Marazzato
- Department of Medicine and Surgery, Circolo Hospital, University of Insubria, Varese, Italy
| | - Roberto De Ponti
- Department of Medicine and Surgery, Circolo Hospital, University of Insubria, Varese, Italy
| | - Roberto Lorusso
- Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Cesare Beghi
- Department of Surgical and Morphological Sciences, Circolo Hospital, University of Insubria, Varese, Italy
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10
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Liu M, Armeni E, Navalkissoor S, Davar J, Sullivan L, Leigh C, O'Mahony LF, Hayes A, Mandair D, Chen J, Caplin M, Toumpanakis C. Cardiac Metastases in Patients with Neuroendocrine Tumours: Clinical Features, Therapy Outcomes, and Prognostic Implications. Neuroendocrinology 2021; 111:907-924. [PMID: 32717739 DOI: 10.1159/000510444] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 07/20/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Cardiac metastases (CM) from neuroendocrine tumours (NET) are rare; however, with the introduction of new molecular imaging modalities, such as 68Ga-DOTATATE PET-CT for NET diagnosis and re-staging, they are now identified more frequently. This study presents a single-institution experience on the NET CM characteristics, management, and prognostic implications. METHODS Between January 1998 and January 2020, 25 NET patients with CM were treated in our unit. A retrospective review of electronic records was performed. Overall survival (OS) was assessed by the Kaplan-Meier method. Cox regression models were used to evaluate the association of various clinical variables with OS. RESULTS The median age in the NET CM cohort was 64 years, with small intestine being the most common primary (84%). Nearly half of the patients suffered either from shortness of breath (48%) or had palpitations (12%). Peptide receptor radionuclide therapy (PRRT) was applied in more than half of the patients (64%), who had an improved trend for a longer median OS compared to those patients who did not receive PRRT (76.0 vs. 14.0 months, p = 0.196). The multivariate analysis demonstrated that concomitant skeletal or pancreatic metastases, as well as N-terminal pro-B-type natriuretic peptide (NT pro-BNP) >2 × upper limit of normal (ULN), were independent poor prognosticators. CONCLUSIONS Clinical features of NET CM ranged from asymptomatic patients to heart failure. Concomitant bone or pancreatic metastases and NT pro-BNP levels >2 ULN predicted shorter survival time. PRRT serves as a feasible therapy with promising survival benefits; however, more data are needed.
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Affiliation(s)
- Man Liu
- Neuroendocrine Tumour Unit, Center for Gastroenterology, ENETS Centre of Excellence, Royal Free London NHS Foundation Trust, London, United Kingdom
- Department of Gastroenterology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Eleni Armeni
- Neuroendocrine Tumour Unit, Center for Gastroenterology, ENETS Centre of Excellence, Royal Free London NHS Foundation Trust, London, United Kingdom
| | | | - Joseph Davar
- Cardiology Department, Royal Free Hospital, London, United Kingdom
| | - Luke Sullivan
- Medical School, University College of London, London, United Kingdom
| | - Charlotte Leigh
- Medical School, University College of London, London, United Kingdom
| | | | - Aimee Hayes
- Neuroendocrine Tumour Unit, Center for Gastroenterology, ENETS Centre of Excellence, Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Dalvinder Mandair
- Neuroendocrine Tumour Unit, Center for Gastroenterology, ENETS Centre of Excellence, Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Jie Chen
- Department of Gastroenterology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Martyn Caplin
- Neuroendocrine Tumour Unit, Center for Gastroenterology, ENETS Centre of Excellence, Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Christos Toumpanakis
- Neuroendocrine Tumour Unit, Center for Gastroenterology, ENETS Centre of Excellence, Royal Free London NHS Foundation Trust, London, United Kingdom,
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11
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Lichtenberger JP, Carter BW, Pavio MA, Biko DM. Cardiac Neoplasms: Radiologic-Pathologic Correlation. Radiol Clin North Am 2020; 59:231-242. [PMID: 33551084 DOI: 10.1016/j.rcl.2020.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Cardiac neoplasms are a diagnostic challenge on many levels. They are rare, their clinical presentation may mimic other much more common cardiac diseases, and they are at an uncommon intersection of oncologic and cardiac imaging. The pathology of primary cardiac neoplasms explains their varied imaging features, for example, calcification in primary cardiac osteosarcomas and T2 hyperintensity in myxomas. Integrating the imaging and pathologic features of cardiac tumors furthers our understanding of the spectrum of appearances of these neoplasms and improves the clinical imager's ability to confidently make a diagnosis.
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Affiliation(s)
- John P Lichtenberger
- The George Washington University Medical Faculty Associates, 900 23rd Street Northwest, Suite G 2092, Washington, DC 20037, USA.
| | - Brett W Carter
- Department of Thoracic Imaging, MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1478, Houston, TX 77030, USA
| | - Michael A Pavio
- Department of Radiology, Walter Reed National Military Medical Center, 4494 North Palmer Road, Bethesda, MD 20889, USA
| | - David M Biko
- Department of Radiology, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA
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12
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Aggeli C, Dimitroglou Y, Raftopoulos L, Sarri G, Mavrogeni S, Wong J, Tsiamis E, Tsioufis C. Cardiac Masses: The Role of Cardiovascular Imaging in the Differential Diagnosis. Diagnostics (Basel) 2020; 10:diagnostics10121088. [PMID: 33327646 PMCID: PMC7765127 DOI: 10.3390/diagnostics10121088] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/06/2020] [Accepted: 12/08/2020] [Indexed: 02/06/2023] Open
Abstract
Cardiac masses are space occupying lesions within the cardiac cavities or adjacent to the pericardium. They include frequently diagnosed clinical entities such as clots and vegetations, common benign tumors such as myxomas and papillary fibroelastomas and uncommon benign or malignant primary or metastatic tumors. Given their diversity, there are no guidelines or consensus statements regarding the best diagnostic or therapeutic approach. In the past, diagnosis used to be made by the histological specimens after surgery or during the post-mortem examination. Nevertheless, evolution and increased availability of cardiovascular imaging modalities has enabled better characterization of the masses and the surrounding tissue. Transthoracic echocardiography using contrast agents can evaluate the location, the morphology and the perfusion of the mass as well as its hemodynamic effect. Transesophageal echocardiography has increased spatial and temporal resolution; hence it is superior in depicting small highly mobile masses. Cardiac magnetic resonance and cardiac computed tomography are complementary providing tissue characterization. The scope of this review is to present the role of cardiovascular imaging in the differential diagnosis of cardiac masses and to propose a step-wise diagnostic algorithm, taking into account the epidemiology and clinical presentation of the cardiac masses, as well as the availability and the incremental value of each imaging modality.
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Affiliation(s)
- Constantina Aggeli
- First Department of Cardiology, General Hospital of Athens Hippokration, University of Athens Medical School, 11527 Athens, Attica, Greece; (Y.D.); (L.R.); (G.S.); (E.T.); (C.T.)
- Correspondence:
| | - Yannis Dimitroglou
- First Department of Cardiology, General Hospital of Athens Hippokration, University of Athens Medical School, 11527 Athens, Attica, Greece; (Y.D.); (L.R.); (G.S.); (E.T.); (C.T.)
| | - Leonidas Raftopoulos
- First Department of Cardiology, General Hospital of Athens Hippokration, University of Athens Medical School, 11527 Athens, Attica, Greece; (Y.D.); (L.R.); (G.S.); (E.T.); (C.T.)
| | - Georgia Sarri
- First Department of Cardiology, General Hospital of Athens Hippokration, University of Athens Medical School, 11527 Athens, Attica, Greece; (Y.D.); (L.R.); (G.S.); (E.T.); (C.T.)
| | - Sophie Mavrogeni
- Department of Cardiology, Onassis Cardiac Surgery Centre, 17674 Kallithea, Attica, Greece;
| | - Joyce Wong
- Department of Cardiology, Harefield Hospital and Royal Brompton Hospital, London UB96JH, UK;
| | - Eleftherios Tsiamis
- First Department of Cardiology, General Hospital of Athens Hippokration, University of Athens Medical School, 11527 Athens, Attica, Greece; (Y.D.); (L.R.); (G.S.); (E.T.); (C.T.)
| | - Costas Tsioufis
- First Department of Cardiology, General Hospital of Athens Hippokration, University of Athens Medical School, 11527 Athens, Attica, Greece; (Y.D.); (L.R.); (G.S.); (E.T.); (C.T.)
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13
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Ali A, Ballard DH, Althobaity W, Christensen A, Geritano M, Ho M, Liacouras P, Matsumoto J, Morris J, Ryan J, Shorti R, Wake N, Rybicki FJ, Sheikh A. Clinical situations for which 3D printing is considered an appropriate representation or extension of data contained in a medical imaging examination: adult cardiac conditions. 3D Print Med 2020; 6:24. [PMID: 32965536 PMCID: PMC7510265 DOI: 10.1186/s41205-020-00078-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 09/04/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Medical 3D printing as a component of care for adults with cardiovascular diseases has expanded dramatically. A writing group composed of the Radiological Society of North America (RSNA) Special Interest Group on 3D Printing (SIG) provides appropriateness criteria for adult cardiac 3D printing indications. METHODS A structured literature search was conducted to identify all relevant articles using 3D printing technology associated with a number of adult cardiac indications, physiologic, and pathologic processes. Each study was vetted by the authors and graded according to published guidelines. RESULTS Evidence-based appropriateness guidelines are provided for the following areas in adult cardiac care; cardiac fundamentals, perioperative and intraoperative care, coronary disease and ischemic heart disease, complications of myocardial infarction, valve disease, cardiac arrhythmias, cardiac neoplasm, cardiac transplant and mechanical circulatory support, heart failure, preventative cardiology, cardiac and pericardial disease and cardiac trauma. CONCLUSIONS Adoption of common clinical standards regarding appropriate use, information and material management, and quality control are needed to ensure the greatest possible clinical benefit from 3D printing. This consensus guideline document, created by the members of the RSNA 3D printing Special Interest Group, will provide a reference for clinical standards of 3D printing for adult cardiac indications.
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Affiliation(s)
- Arafat Ali
- Department of Radiology, University of Cincinnati Medical Center, Cincinnati, OH, USA.
| | - David H Ballard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Waleed Althobaity
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Andy Christensen
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
| | | | - Michelle Ho
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Peter Liacouras
- 3D Medical Applications Center, Walter Reed National Military Medical Center, Washington, DC, USA
| | - Jane Matsumoto
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | - Justin Ryan
- Rady Children's Hospital, San Diego, CA, USA
| | - Rami Shorti
- Intermountain Healthcare, South Jordan, UT, USA
| | - Nicole Wake
- Department of Radiology, Montefiore Medical Center, Bronx, NY, USA
| | - Frank J Rybicki
- Department of Radiology, University of Cincinnati Medical Center, Cincinnati, OH, USA
| | - Adnan Sheikh
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
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14
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Davar J, Lazoura O, Caplin ME, Toumpanakis C. Features of carcinoid heart disease identified by cardiac computed tomography. J Cardiovasc Comput Tomogr 2020; 15:167-174. [PMID: 33004299 DOI: 10.1016/j.jcct.2020.08.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 08/11/2020] [Accepted: 08/14/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Carcinoid heart disease (HD) is a rare form of valvular heart disease, the features of which have not been fully described by cardiac computed tomography (CT). METHODS All patients with carcinoid HD that underwent cardiac CT, either preoperatively or for assessment of coronary arteries, between Apr-2006 and Dec-2019 at the Royal Free Hospital, UK, were reviewed. RESULTS Of 32 patients with carcinoid HD, 29 (91%) had heart valve involvement. Abnormalities of the tricuspid and pulmonary valves were present in all patients, affecting all three leaflets in 23/26 (89%) unoperated patients for both valves. The aortic valve was affected in 4/29 (14%) patients and the mitral valve in 5/29 (17%). Left heart valves were affected in 6/29 (21%) patients. One patient (1/29; 3%) had all four valves affected. Severe changes with significant valvular regurgitation were seen in ≥75% of patients with tricuspid, pulmonary, and aortic valve abnormalities. Three patients had carcinoid myocardial metastases (3/32; 9%) and one patient had constrictive pericarditis (1/32; 3%). Ten patients had surgery of whom four (40%) had invasive coronary angiography preoperatively. Ten patients had a patent foramen ovale. Cardiac CT allowed an accurate assessment of damage to different leaflets/cusps, particularly of the pulmonary valve, where visualization with echocardiography was often (3/8; 38%) incomplete. CONCLUSION Cardiac CT is a powerful tool for assessment of cardiac valve abnormalities, coronary arteries and the spatial relationship of coronary arteries with myocardial metastasis in patients with carcinoid HD, and should form part of multimodal imaging of this complex pathology.
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Affiliation(s)
- Joseph Davar
- Carcinoid Heart Disease Clinic, Department of Cardiology, Royal Free Hospital, London, United Kingdom.
| | - Olga Lazoura
- Department of Radiology, Royal Free Hospital, London, United Kingdom.
| | - Martyn E Caplin
- Neuroendocrine Tumour Unit, ENETS Centre of Excellence, Royal Free Hospital, London, United Kingdom.
| | - Christos Toumpanakis
- Neuroendocrine Tumour Unit, ENETS Centre of Excellence, Royal Free Hospital, London, United Kingdom.
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15
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Pradella S, Grazzini G, Letteriello M, De Amicis C, Grassi R, Maggialetti N, Carbone M, Palumbo P, Carotti M, Di Cesare E, Giovagnoni A, Cozzi D, Miele V. Masses in right side of the heart: spectrum of imaging findings. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:60-70. [PMID: 32945280 PMCID: PMC7944673 DOI: 10.23750/abm.v91i8-s.9940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 06/08/2020] [Indexed: 11/25/2022]
Abstract
Primary heart tumors are rare, benign tumors represent the majority of these. If a cardiac mass is found, the probability that it is a metastasis or a so-called “pseudo-mass” is extremely higher than a primary tumor. The detection of a heart mass during a transthoracic echocardiography (TE) is often unexpected. The TE assessment can be difficult, particularly if the mass is located at the level of the right chambers. Cardiac Computed Tomography (CCT) can be useful in anatomical evaluation and Cardiac Magnetic Resonance (CMR) for masses characterization as well. We provide an overview of right cardiac masses and their imaging futures. (www.actabiomedica.it)
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Affiliation(s)
- Silvia Pradella
- Department of Radiology, Careggi University Hospital, Florence, Italy.
| | - Giulia Grazzini
- Department of Radiology, Careggi University Hospital, Florence, Italy.
| | - Mayla Letteriello
- Department of Radiology, Careggi University Hospital, Florence, Italy.
| | | | - Roberta Grassi
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.
| | - Nicola Maggialetti
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Campobasso, Italy.
| | - Mattia Carbone
- Department of Radiology, S. Giovanni and Ruggi D'Aragona Hospital, Salerno, Italy.
| | - Pierpaolo Palumbo
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Marina Carotti
- Università politecnica delle Marche, School of Medicine and University Hospital "Umberto I-Lancisi-Salesi", Department of Radiology, Ancona, Italy.
| | - Ernesto Di Cesare
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Andrea Giovagnoni
- Università politecnica delle Marche, School of Medicine and University Hospital "Umberto I-Lancisi-Salesi", Department of Radiology, Ancona, Italy.
| | - Diletta Cozzi
- Department of Radiology, Careggi University Hospital, Florence, Italy.
| | - Vittorio Miele
- Department of Radiology, Careggi University Hospital, Florence, Italy.
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Li X, Chen Y, Liu J, Xu L, Li Y, Liu D, Sun Z, Wen Z. Cardiac magnetic resonance imaging of primary cardiac tumors. Quant Imaging Med Surg 2020; 10:294-313. [PMID: 31956550 DOI: 10.21037/qims.2019.11.13] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Cardiac magnetic resonance (CMR) offers superior advantages in cardiac imaging due to supplying a greater field of view, excellent soft-tissue imaging, and multiplanar imaging capabilities. CMR imaging can evaluate the characteristics of cardiac tumors by visualizing the relationship between the tumor and surrounding tissues, and plays a vital role in assisting the formulation of the surgical plan, the assessment of tumor progression, and the monitoring of postoperative tumor recurrence and metastasis. In this review, we present the clinical manifestations and imaging features of different cardiac tumors. The superior performance of CMR in preoperative diagnosis, surgical treatment, and postoperative follow-up of patients with heart tumors are also highlighted.
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Affiliation(s)
- Xiaodan Li
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Yan Chen
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Jiayi Liu
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Lei Xu
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Yu Li
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Dongting Liu
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Zhonghua Sun
- Discipline of Medical Radiation Sciences, School of Molecular and Life Sciences, Curtin University, Perth, Australia
| | - Zhaoying Wen
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
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18F-FDG PET/CT in diagnostic and prognostic evaluation of patients with cardiac masses: a retrospective study. Eur J Nucl Med Mol Imaging 2019; 47:1083-1093. [DOI: 10.1007/s00259-019-04632-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 11/18/2019] [Indexed: 12/18/2022]
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