Cardiac tumors diagnostic study of choice

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Dheeraj Makkar, M.D.[2]

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.
• 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.
• 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.

Conclusion

Echocardiography continues to be the best first imaging technique for identifying cardiac/pericardial malignancies. Cardiac MRI is the best non-invasive technique; 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. Histopathological analysis of any excised cardiac mass is the diagnostic gold standard. It enables the determination of benign or malignant origin and accurate histotype.