Integrated XXXX -PET/MRI in the assessment of cardiac masses: A pilot study.

@entity1 @entity419 @entity242 @entity3291 @entity1735 @entity2109 @entity2288 @entity299 @entity715
UNASSIGNED: The objective of the present study was to evaluate whether integrated @entity419 -PET/MRI can improve the diagnostic workup in @entity1 with cardiac masses. METHODS: Twenty @entity1 were prospectively assessed using integrated cardiac @entity419 -PET/MRI: 16 @entity1 with cardiac masses of unknown identity and four @entity1 with @entity299 after surgical therapy. All scans were performed on an integrated 3-T PET/MR device (mMR Biograph, Siemens Healthcare, Erlangen, Germany). The MR protocol consisted of HASTE, cine and T2-weighted images as well as T1-weighted images before and after injection of @entity2288 . PET data acquisition was performed simultaneously to the MR scan after injection of 199  58 MBq @entity419 . @entity1 were prepared with a high-fat, low- @entity1735 diet in a period of 24 hours before the examination and 50 IU/kg of unfractionated heparin were administered intravenously 15 minutes prior the @entity419 injection. RESULTS: Cardiac masses were diagnosed as follows: 3 x metastases, 1 x direct tumor infiltration via pulmonary vein, 2 x local relapse of @entity242 after surgery, 1 @entity2109 , 2 x scar/patch tissue after surgery of @entity242 , 4 x @entity3291 , 1 x fibroelastoma, 3 x caseous calcification of mitral annulus (CCMA), 3 x @entity715 . SUVmax in malignant lesions was significantly higher than in non-malignant cases (13.2  6.2 vs. 2.3  1.2, P = 0.0004). Using a threshold of >=  5.2, SUVmax was found to yield 100% sensitivity and 92% specificity for the differentiation between malignant and non-malignant cases. T2-weighted hyperintensity and contrast-enhancement both yielded 100% sensitivity, but a weak specificity of 54% and 46%, respectively. Morphologic tumor features as assessed by cine MRI yielded 86% sensitivity and 92% specificity. Consent reading using all available MR features yielded 100% sensitivity and 92% specificity. A Boolean 'AND' combination of SUVmax >=  5.2 with consent MRI reading improved sensitivity and specificity to 100%. CONCLUSION: In selected @entity1 , @entity419 -PET/MRI can improve the noninvasive diagnosis and follow-up of cardiac masses.
