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Multicenter Study
. 2021 Dec 28;43(1):71-80.
doi: 10.1093/eurheartj/ehab635.

Cardiovascular magnetic resonance imaging in suspected cardiac tumour: a multicentre outcomes study

Chetan Shenoy  1 , John D Grizzard  2 , Dipan J Shah  3 , Mahwash Kassi  3 , Michael J Reardon  3 , Marianna Zagurovskaya  2 , Han W Kim  4 , Michele A Parker  4 , Raymond J Kim  4
Affiliations
Multicenter Study

Cardiovascular magnetic resonance imaging in suspected cardiac tumour: a multicentre outcomes study

Chetan Shenoy et al. Eur Heart J. .

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.

Keywords: Cardiac magnetic resonance; Cardiac masses; Cardiac tumours; Cardio-oncology; Diagnosis; Prognosis.

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Figures

None
In patients with suspected cardiac tumour, CMR has high diagnostic accuracy and is an excellent independent predictor of long-term mortality.
Figure 1
Figure 1
Stepwise algorithm used for cardiovascular magnetic resonance interpretation of patients with suspected cardiac tumour. CMR, cardiovascular magnetic resonance; LGE, late gadolinium enhancement; SSFP, steady-state free precession.
Figure 2
Figure 2
Kaplan–Meier curves for death during follow-up stratified by cardiovascular magnetic resonance diagnoses. CMR, cardiovascular magnetic resonance.
See this image and copyright information in PMC

Comment in

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