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.
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.