Jin Hur MD, Abstract Co-Author: Nothing to Disclose

Jae Seung Seo, Presenter: Nothing to Disclose

Young Jin Kim MD, Abstract Co-Author: Nothing to Disclose

Hye-Jeong Lee MD, Abstract Co-Author: Nothing to Disclose

Yoo Jin Hong, Abstract Co-Author: Nothing to Disclose

Ji Eun Nam MD, Abstract Co-Author: Nothing to Disclose

Byoung Wook Choi MD, Abstract Co-Author: Nothing to Disclose

Kyu Ok Choe MD, Abstract Co-Author: Nothing to Disclose

Accurate detection and diagnosis of cardiac thrombi and tumors are important as they provide a substrate for embolic events and a rationale for anticoagulation or surgical resection. The purpose of this study was to evaluate the diagnostic value of dual-energy cardiac computed tomography (CCT) in differentiating cardiac tumors from thrombi.

We prospectively enrolled 18 patients who had cardiac mass on echocardiography or transeophageal echocardiography (TEE). All patients underwent dual-energy CCT using gemstone spectral imaging (GSI) mode (GE HD750, nonelectrocardiography-gated). The scan was started 180 seconds later, after the end of the test bolus scan. For quantitative analysis, iodine concentration was measured on CT images for cardiac mass. Pathological results or follow up with echocardiography were used as a final diagnosis.

There were a total of 8 cardiac tumors and 10 thrombi. All cardiac tumors and thrombi were correctly detected by dual-energy CCT. On CT, the mean iodine concentration (mg/cc) was 4.25 ± 1.37 for tumor and 1.41 ± 0.62 for thrombus, respectively (p = 0.001). However, the mean iodine concentration (mg/cc) was not significantly different between malignant and benign tumors (n = 3; 3.81 ± 1.25 versus n = 5; 4.41 ± 1.48, p = 0.629). The mean effective radiation dose was 4.02 mSv.

Dual-energy CCT using GSI mode is a highly sensitive modality in detecting intracardiac masses and has the ability to differentiate tumors from thrombi.

Dual-energy CCT could be a helpful complementary tool to differentiate tumor from thrombus in cases in which echocardiography or single-source CT is inconclusive.

Hur, J, Seo, J, Kim, Y, Lee, H, Hong, Y, Nam, J, Choi, B, Choe, K, Dual-Energy Cardiac Computed Tomography in Differentiating Cardiac Tumor from Thrombus: Initial Experience.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11011010.html