Kerstin Ulrike Bauner MD, Presenter: Nothing to Disclose

Steven Sourbron PhD, Abstract Co-Author: Nothing to Disclose

Christoph Schmitz, Abstract Co-Author: Nothing to Disclose

Maximilian F. Reiser MD, Abstract Co-Author: Nothing to Disclose

Armin Michael Huber MD, Abstract Co-Author: Nothing to Disclose

To determine the diagnostic value of magnetic resonance (MR) first pass perfusion imaging in differentiation of benign and malignant cardiac tumors.

21 patients with cardiac tumors (myxoma (n=7), rhabdomyoma (n=2), angiolipoma (n=1), angiosarcoma (n=5), rhabdomyosarcoma (n=1), leiomyosarcoma (n=2), lymphoma (n=1), metastasis (n=2, sarcoma and melanoma)) were examined (histopathologic correlation was present in all cases). A saturation recovery T1w fast GRE technique was implemented for tumor perfusion imaging. Postprocessing was performed on a remote workstation using an in-house developed software and the following parameters were assessed for tumor tissue, normal myocardium and the arterial input function (AIF): 1. maximum-contrast-enhancement-ratio (CERmax[%]) and 2. the maximum-slope-of-CER-curve (slopeCER[%/sec]). Additionaly the CERmax and the slopeCER of tumor relative to normal myocardium and relative to the AIF were built. Significant differences of CERmax and the slopeCER between benign and malignant tumor entities were calculated and the sensitivities and specificities of these parameters for differentiation malignant from benign lesions were assessed.

CERmax and slopeCER of malignant cardiac tumors was significantly higher compared to benign lesions (p<0.001) while the CERmax and slopeCER of myocardium and AIF were not significantly different. CERmax(tumor/myo) and CERmax(tumor/AIF) were significantly higher in malignant cardiac tumors compared to benign lesions (p=0.0015 and p=0.0016) as was the slopeCER(tumor/myo) (p=0.037). The calculated sensitivities and specificities of CERmax(tumor/myo), CERmax(tumor/AIF) and the slopeCER(tumor/myo) for differentiating malignant from benign lesions resulted in 100% and 63.3%, 100% and 63.3% and 100% and 54.5% respectively with cut-off values of 1.8, 1.08 and 0.20.

Dynamic MR imaging delineates significant differences in perfusion between malignant and benign cardiac tumors. Higher CERmax of tumor tissue relative to normal myocardium and relative to the AIF indicates malignancy as well as a high slopeCER of tumor in relation to normal myocardium.

Results of perfusion examinations contribute additional information to the characterization of a cardiac lesion, which may be crucial in the decision of therapeutic procedures.

Bauner, K, Sourbron, S, Schmitz, C, Reiser, M, Huber, A, Differences in Perfusion of Benign and Malignant Cardiac Tumors.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9003064.html