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

Chetan Shenoy, John D. Grizzard, DIpan J. Shah, Mahwash Kassi, Michael J. Reardon, Marianna Zagurovskaya, Han W. Kim, Michele A. Parker, Raymond J. Kim

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)71-80
Number of pages10
JournalEuropean heart journal
Volume43
Issue number1
DOIs
StatePublished - Jan 1 2022

Keywords

  • Cardiac magnetic resonance
  • Cardiac masses
  • Cardiac tumours
  • Cardio-oncology
  • Diagnosis
  • Prognosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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