Cardiac MR highly accurate for detecting cardiac tumors: Study
USA: Cardiovascular magnetic resonance (CMR) has high diagnostic accuracy in patients with suspected cardiac tumors, reveals a recent study published in the European Heart Journal. Patients with CMR diagnoses of no mass, pseudo mass, and benign tumor were found to have similar long-term mortality. This implies that CMR diagnosis is a powerful tool to predict mortality incremental to clinical risk factors.
Prior to this study, it was known that CMR imaging is a key diagnostic tool for evaluating patients with suspected cardiac tumors. Patient management is guided by the CMR diagnosis including no further testing if a mass is excluded or if only a pseudo mass is found. However, no outcomes studies have validated this approach.
Cardiovascular magnetic resonance (CMR) imaging is a key diagnostic tool for the evaluation of patients with suspected cardiac tumors. Patient management is guided by the CMR diagnosis, including no further testing if a mass is excluded or if only a pseudo mass is found. However, there are no outcomes studies validating this approach. To fill this knowledge gap, Raymond J Kim, Duke University Medical Center, Durham, NC, USA, and colleagues thus aimed to validate this approach in a multicentre study.
The study included patients undergoing clinical CMR for suspected cardiac tumours, CMR diagnoses were assigned as no mass, pseudo mass, thrombus, benign tumor, or malignant tumor. A final diagnosis was determined after follow-up using all available data. The primary endpoint was all-cause mortality.
Based on the study, the researchers found the following:
- Among 903 patients, the CMR diagnosis was no mass in 25%, pseudo mass in 16%, thrombus in 16%, benign tumor in 17%, and malignant tumor 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 pseudo mass and benign tumor had similar mortality to those with no mass, whereas those with malignant tumor [hazard ratio (HR) 3.31] and thrombus [HR 1.46] 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.
Kim and the team concluded, "the CMR diagnosis is a powerful independent predictor of mortality incremental to clinical risk factors."
Reference:
Chetan Shenoy, John D Grizzard, Dipan J Shah, Mahwash Kassi, Michael J Reardon, Marianna Zagurovskaya, Han W Kim, Michele A Parker, Raymond J Kim, Cardiovascular magnetic resonance imaging in suspected cardiac tumour: a multicentre outcomes study, European Heart Journal, 2021;, ehab635, https://doi.org/10.1093/eurheartj/ehab635
