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Diagnostics
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Noninvasive Diagnosis of Cardiac Tumors
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Noninvasive Diagnosis of Cardiac Tumors

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (18 November 2022) | Viewed by 14339

Special Issue Editor

Dr. Soraya El Ghannudi

E-Mail Website
Guest Editor
1. Radiology and Nuclear medicine Departments, University Hospital of Strasbourg, 1 Place de l'Hôpital, 6700 Strasbourg, France
2. Nuclear Medicine and Molecular Imaging, ICANS, University Hospitals of Strasbourg, rue Albert Calmette, 67093 Strasbourg, France
Interests: cardiovascular imaging; cardiac magnetic resonance imaging; cardiac CT; positron emission tomography/CT; PET/CMR; molecular imaging; echocardiography; multimodality imaging; cardio-oncology; cardiomyopathies

Special Issue Information

Dear Colleague, 

Cardiac tumors are rare diseases, either primary or metastatic. Primary cardiac tumors include benign and malignant tumors. Cardiac tumors have heterogeneous clinical presentation ranging from asymptomatic incidental discovery to life-threatening symptoms. Pericardial effusion or cardiac tamponade is rarely the early clinical presentation of a cardiac involvement of malignant disease, although 90% of lesions are clinically silent. In patients with cardiac masses, it is mandatory to accurately define their malignant potential, the exact anatomic location, and the response to treatment in order to optimize the therapeutic strategy.

The majority of articles report the use of noninvasive imaging for the diagnosis of those tumors in a limited number of cases.

Transthoracic echocardiography (TTE) is widely used because of its high availability and lack of patient exposure to ionizing radiation. However, TTE could be unreliable in the initial detection of primary or metastatic cardiac involvement mainly because of its inadequate spatial resolution and its operator-dependent nature, making it highly subjective to interpretative errors. Cardiac magnetic resonance imaging (CMR) is one of the most comprehensive imaging modalities for the diagnosis and characterization of cardiac tumors and is useful for risk stratification and clinical decision making. Cardiac CT is a reliable complementary tool for CMR in the evaluation of cardiac masses and offers a valuable diagnostic alternative in those patients with contraindications to CMR. Nuclear medicine techniques allow a characterization of tumoral functional status and can detect cardiac metastatic disease at an early stage. The combination of anatomic and functional imaging modalities such as CMR and positron emission tomography (PET) may be of interest in cardiac tumor tissue characterization and cardiac tumor management.

There are still a few studies evaluating the added value of the use of multimodality imaging for the diagnosis and tissue characterization of cardiac tumors.

Dr. Soraya El Ghannudi
Guest Editor

Manuscript Submission Information

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cardiac tumors
  • benign tumors
  • cardiac malignancies
  • diagnosis of cardiac tumors
  • echocardiography
  • cardiac magnetic resonance imaging
  • positron emission tomography/CT
  • PET/CMR
  • molecular imaging
  • morpho-functional assessment
  • multimodality imaging
  • tissue cardiac tumor characterization

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Published Papers (6 papers)

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Research

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10 pages, 2685 KiB  
Article
Myocardial Radiomics Texture Features Associated with Increased Coronary Calcium Score—First Results of a Photon-Counting CT
by Isabelle Ayx, Hishan Tharmaseelan, Alexander Hertel, Dominik Nörenberg, Daniel Overhoff, Lukas T. Rotkopf, Philipp Riffel, Stefan O. Schoenberg and Matthias F. Froelich
Diagnostics 2022, 12(7), 1663; https://doi.org/10.3390/diagnostics12071663 - 8 Jul 2022
Cited by 19 | Viewed by 2106
Abstract
The coronary artery calcium score is an independent risk factor of the development of adverse cardiac events. The severity of coronary artery calcification may influence the myocardial texture. Due to higher spatial resolution and signal-to-noise ratio, new CT technologies such as PCCT may [...] Read more.
The coronary artery calcium score is an independent risk factor of the development of adverse cardiac events. The severity of coronary artery calcification may influence the myocardial texture. Due to higher spatial resolution and signal-to-noise ratio, new CT technologies such as PCCT may improve the detection of texture alterations depending on the severity of coronary artery calcification. In this retrospective, single-center, IRB-approved study, left ventricular myocardium was segmented and radiomics features were extracted using pyradiomics. The mean and standard deviation with the Pearson correlation coefficient for correlations of features were calculated and visualized as boxplots and heatmaps. Random forest feature selection was performed. Thirty patients (26.7% women, median age 58 years) were enrolled in the study. Patients were divided into two subgroups depending on the severity of coronary artery calcification (Agatston score 0 and Agatston score ≥ 100). Through random forest feature selection, a set of four higher-order features could be defined to discriminate myocardial texture between the two groups. When including the additional Agatston 1–99 groups as a validation, a severity-associated change in feature intensity was detected. A subset of radiomics features texture alterations of the left ventricular myocardium was associated with the severity of coronary artery calcification estimated by the Agatston score. Full article
(This article belongs to the Special Issue Noninvasive Diagnosis of Cardiac Tumors)
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Review

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19 pages, 3231 KiB  
Review
Multimodality Imaging of Benign Primary Cardiac Tumor
by Yixia Lin, Wenqian Wu, Lang Gao, Mengmeng Ji, Mingxing Xie and Yuman Li
Diagnostics 2022, 12(10), 2543; https://doi.org/10.3390/diagnostics12102543 - 20 Oct 2022
Cited by 13 | Viewed by 3345
Abstract
Primary cardiac tumors (PCTs) are rare, with benign PCTs being relatively common in approximately 75% of all PCTs. Benign PCTs are usually asymptomatic, and they are found incidentally by imaging. Even if patients present with symptoms, they are usually nonspecific. Before the application [...] Read more.
Primary cardiac tumors (PCTs) are rare, with benign PCTs being relatively common in approximately 75% of all PCTs. Benign PCTs are usually asymptomatic, and they are found incidentally by imaging. Even if patients present with symptoms, they are usually nonspecific. Before the application of imaging modalities to the heart, our understanding of these tumors is limited to case reports and autopsy studies. The advent and improvement of various imaging technologies have enabled the non-invasive evaluation of benign PCTs. Although echocardiography is the most commonly used imaging examination, it is not the best method to describe the histological characteristics of tumors. At present, cardiac magnetic resonance (CMR) and cardiac computed tomography (CCT) are often used to assess benign PCTs providing detailed information on anatomical and tissue features. In fact, each imaging modality has its own advantages and disadvantages, multimodality imaging uses two or more imaging types to provide valuable complementary information. With the widespread use of multimodality imaging, these techniques play an indispensable role in the management of patients with benign PCTs by providing useful diagnostic and prognostic information to guide treatment. This article reviews the multimodality imaging characterizations of common benign PCTs. Full article
(This article belongs to the Special Issue Noninvasive Diagnosis of Cardiac Tumors)
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Other

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8 pages, 1545 KiB  
Case Report
Multimodality Imaging Evaluation of Coronary IgG4-Related Disease: A “Tumor-Like” Cardiac Lesion
by Ludovica R. M. Lanzafame, Maria Ludovica Carerj, Giovanna Rizzo, Fabio Minutoli, Giuseppe M. Bucolo, Natasha Irrera, Giuseppe Muscogiuri, Sandro Sironi, Alfredo Blandino and Tommaso D’Angelo
Diagnostics 2022, 12(11), 2814; https://doi.org/10.3390/diagnostics12112814 - 16 Nov 2022
Cited by 5 | Viewed by 2034
Abstract
Immunoglobulin G4-related disease (IgG4-RD) is a systemic immune-mediated fibro-inflammatory disorder. Coronary IgG4-RD has been scarcely reported and may present as “tumor-like” lesions. These pseudo-masses may be underdiagnosed mainly due to a vague clinical picture that can vary from complete lack of symptoms to [...] Read more.
Immunoglobulin G4-related disease (IgG4-RD) is a systemic immune-mediated fibro-inflammatory disorder. Coronary IgG4-RD has been scarcely reported and may present as “tumor-like” lesions. These pseudo-masses may be underdiagnosed mainly due to a vague clinical picture that can vary from complete lack of symptoms to acute coronary syndrome or sudden cardiac death. Early recognition of coronary IgG4-RD is essential to monitor disease activity and prevent life-threatening complications. We report a comprehensive non-invasive imaging evaluation of a patient affected by coronary IgG4-RD, which was diagnosed as an incidental finding during routine pre-laparoscopic cholecystectomy checkup. Non-invasive imaging revealed the presence of a peri-coronary soft-tissue mass that was stable at 12 months follow-up. Full article
(This article belongs to the Special Issue Noninvasive Diagnosis of Cardiac Tumors)
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3 pages, 683 KiB  
Interesting Images
Echocardiography, Computed Tomography and Magnetic Resonance Imaging in the Differential Diagnosis of a Tumor in the Left Atrium of the Heart
by Malgorzata Zalewska-Adamiec, Hanna Bachorzewska-Gajewska and Slawomir Dobrzycki
Diagnostics 2022, 12(7), 1749; https://doi.org/10.3390/diagnostics12071749 - 20 Jul 2022
Viewed by 1479
Abstract
Cardiac tumors are rare. Most often they are metastatic tumors, while primary tumors are much less common. In addition to proliferative changes in the heart, there are also non-neoplastic structures, such as thrombus, vegetation or inflammatory tumors. All structures with a heart tumor [...] Read more.
Cardiac tumors are rare. Most often they are metastatic tumors, while primary tumors are much less common. In addition to proliferative changes in the heart, there are also non-neoplastic structures, such as thrombus, vegetation or inflammatory tumors. All structures with a heart tumor morphology require a lot of imaging studies in order to diagnose them and plan treatment without performing a biopsy. We present a case of a 75-year-old female patient who had moving masses in the left atrium on echocardiography. Computed tomography of the chest was performed, which did not clearly explain the nature of the structure observed in the left atrium. The Heart Team decided to perform another test—magnetic resonance imaging (MRI) of the heart in 3 months to differentiate the lesion. The examination was performed after 3 months of warfarin therapy and there were no masses in the left atrium, which confirmed that the observed tumor was a thrombus. Full article
(This article belongs to the Special Issue Noninvasive Diagnosis of Cardiac Tumors)
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12 pages, 2669 KiB  
Brief Report
Cutting-Edge Imaging of Cardiac Metastases from Neuroendocrine Tumors: Lesson from a Case Series
by Soraya El Ghannudi, Eric Ouvrard, Nidaa Mikail, Benjamin Leroy Freschini, Thomas H. Schindler and Alessio Imperiale
Diagnostics 2022, 12(5), 1182; https://doi.org/10.3390/diagnostics12051182 - 9 May 2022
Cited by 4 | Viewed by 1929
Abstract
With the increasing availability of high-performance medical imaging for the management of patients with neuroendocrine tumors (NETs), a progressive growth of asymptomatic and incidentally detected cardiac metastases (CMs) has been observed in the recent years. In clinical practice, CMs of NENs are often [...] Read more.
With the increasing availability of high-performance medical imaging for the management of patients with neuroendocrine tumors (NETs), a progressive growth of asymptomatic and incidentally detected cardiac metastases (CMs) has been observed in the recent years. In clinical practice, CMs of NENs are often incidentally detected by whole-body 68Ga-labeled somatostatin analogs or 18F-fluorodihydroxyphenylalanine positron emission tomography/computed tomography, and afterwards accurately characterized by cardiac magnetic resonance (CMR) and/or gated cardiac computed tomography when CMR is contraindicated or not available. The interpreting physician should familiarize with the main imaging features of CM, a finding that may be encountered in NETs patients more than previously thought. Herein, we present a case series of four patients with CMs from small-intestine NETs highlighting strengths and weaknesses of a multimodality imaging approach in clinical practice. Full article
(This article belongs to the Special Issue Noninvasive Diagnosis of Cardiac Tumors)
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7 pages, 2317 KiB  
Case Report
The Importance of Cardiac Computed Tomography in the Diagnosis of Caseous Calcification of the Mitral Annulus—Case Reports
by Paweł Gać, Przemysław Cheładze and Rafał Poręba
Diagnostics 2022, 12(3), 667; https://doi.org/10.3390/diagnostics12030667 - 9 Mar 2022
Viewed by 2552
Abstract
Mitral annular calcification (MAC) is a common pathology of the mitral valve. In rare cases, calcifications occur in the mitral annulus degenerate serous; the caseous calcification of the mitral annulus (CCMA) then develops. Detection of CCMA is often random and requires differentiation from [...] Read more.
Mitral annular calcification (MAC) is a common pathology of the mitral valve. In rare cases, calcifications occur in the mitral annulus degenerate serous; the caseous calcification of the mitral annulus (CCMA) then develops. Detection of CCMA is often random and requires differentiation from heart tumors or an abscess. The paper presents two cases of patients with ambiguous focal lesions of the mitral valve in echocardiography. In the first case, the cardiac computed tomography (CCT) showed a spherical, slightly irregular structure measuring approximately 33 × 22 mm, which was in contact with the posterior mitral valve leaflet from the lumen of the left ventricle. The lesion was heterogeneously intense, with an average density of about 500 HU and up to 975 HU on the periphery; it was not enhanced after the administration of a contrast agent. In the second case, the CCT revealed a heterogeneous, highly calcified structure in the peripheral zone and intermediate density in the central zone in the topography of the posterior mitral valve leaf, with dimensions up to about 41 × 31 mm in the plane of the valve leaflet, passing into the lumen of the left ventricle along its inferolateral wall to a depth of about 3.5 cm. In both cases, CCT enabled the diagnosis of CCMA. In conclusion, cardiac computed tomography may be decisive in the case of suspected caseous calcification of the mitral annulus where there is ambiguous echocardiography. Full article
(This article belongs to the Special Issue Noninvasive Diagnosis of Cardiac Tumors)
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