Cardiac tumors diagnostic study of choice

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Template:Dj

Multiple cardiovascular imaging modalities could be used to outline the structure of heart mass and its potential implications on the function.

  • The primary objective of cardiovascular imaging is to define the location, extent, and vascularity of the tumor and to determine any hemodynamic effects, tumor and evaluate for invasion into myopericardium.
  • All patients should undergo transthoracic echocardiography (TTE) in 2D.
  • Contrast echocardiography permits the evaluation of tumor vasculature and hence facilitates the distinction between vascular malignancies and avascular tumors or thrombus.[1]
  • Transesophageal echocardiography is particularly beneficial for visualizing atria-based malignancies when the exact location of attachment cannot be determined using transthoracic echocardiography (TTE) and evaluating their connection to the venae cavae.[2]
  • Cardiac MRI sequencing can be utilized to determine the tumor's fat, water, vasculature, and ferrous content.

In secondary cardiac tumors, computed tomography (CT) may be useful for screening prospective primary tumor locations in the chest, abdomen, and pelvis.[3]

Conclusion

Echocardiography continues to be the gold standard initial imaging technique for identifying cardiac/pericardial malignancies. Cardiac MRI gives supplementary information for tissue characterization, and evaluation of myocardial infiltration. CT is essential to determine the presence of extracardiac metastatic dissemination. The precise combination of imaging modalities should be individualized for each patient.

References

  1. Bhattacharyya S, Khattar R, Senior R (2013). "Characterisation of intra-cardiac masses by myocardial contrast echocardiography". Int J Cardiol. 163 (1): e11–3. doi:10.1016/j.ijcard.2012.06.098. PMID 22805540.
  2. Geibel A, Kasper W, Keck A, Hofmann T, Konstantinides S, Just H (1996). "Diagnosis, localization and evaluation of malignancy of heart and mediastinal tumors by conventional and transesophageal echocardiography". Acta Cardiol. 51 (5): 395–408. PMID 8922046.
  3. Hoffmann U, Globits S, Schima W, Loewe C, Puig S, Oberhuber G; et al. (2003). "Usefulness of magnetic resonance imaging of cardiac and paracardiac masses". Am J Cardiol. 92 (7): 890–5. doi:10.1016/s0002-9149(03)00911-1. PMID 14516903.