MRI scanner

Cardiac MRI key diagnostic tool in suspected cardiac tumour, predictive of prognosis

By Ahmed El-Medany

This research by Shenoy et al included 903 individuals undergoing CMRI for suspected cardiac tumour.

The cardiac MRI diagnosis of ‘no mass’ was made for 25% of the cohort, ‘pseudomass’ for 16%, thrombus for 16%, ‘benign tumour’ for 17%, and ‘malignant tumour’ for 23%. The MRI diagnosis was accurate in 98.4% of patients.

The estimated 5-year rate of all-cause mortality was 22% for patients with no mass, 26% for pseudomass, 17% for benign tumour, 36% for thrombus, and 73% for malignant tumour.

The researchers determined that the following were each independently associated with all-cause mortality in this cohort:

  • age (HR per 5-year increase = 1.09; 95% CI, 1.04-1.13);
  • smoking (HR = 1.37; 95% CI, 1.11-1.69);
  • left ventricular ejection fraction (HR per 5% decrease = 1.05; 95% CI, 1.01-1.1);
  • extracardiac malignancy (HR = 2.32; 95% CI, 1.81-2.97);
  • cardiac MRI diagnosis of thrombus (HR relative to diagnosis of no mass = 1.46; 95% CI, 1-2.11); and
  • cardiac MRI diagnosis of malignant tumour (HR relative to diagnosis of no mass = 3.31; 95% CI, 2.4-4.57).

The addition of the CMRI diagnosis to a clinical model lacking CMRI increased the X2 statistic from 215.8 to 299.8 (P < .001), indicating that CMRI diagnosis had incremental value for patients with and without an extracardiac malignancy.

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Source: Shenoy C, Grizzard JD, Shah DJ, Kassi M, Reardon MJ, Zagurovskaya M, Kim HW, Parker MA, Kim RJ. Cardiovascular magnetic resonance imaging in suspected cardiac tumour: a multicentre outcomes study. European heart journal. 2021 Sep 21.