Combined PET/CT with thoracic contrast-enhanced CT in assessment of primary cardiac tumors in adult patients

• Published in: EJNMMI research 2020-07, Vol.10 (1), p.75-75, Article 75
• Main Authors: Liu, En-Tao, Sun, Tao-Tao, Dong, Hao-Jian, Wang, Si-Yun, Chen, Ze-Rui, Liu, Chao, Shao, Dan, Lian, Zhou-Yang, Xie, Qiu, Wang, Shu-Xia
• Format: Article
• Language: English
• Subjects: 18F-Fluorodeoxyglucose (18F-FDG); Accuracy; Cardiac Imaging; Diagnosis; Diagnostic systems; Fluorine isotopes; Imaging; Medical imaging; Medicine; Medicine & Public Health; Nuclear Medicine; Oncology; Original Research; Orthopedics; Performance evaluation; PET/CT; Positron emission; Primary cardiac tumors; Qualitative analysis; Radiology; Tomography; Tomography, X-ray computed; Tumors
• ISSN: 2191-219X; 2191-219X
• DOI: 10.1186/s13550-020-00661-x

Background 18 F-FDG PET/CT is a key molecular imaging modality to noninvasively assess and differentiate benign and malignant cardiac tumors. However, few benign cardiac tumors can be characterized by increased 18 F-FDG uptake, which makes differential diagnosis difficult. This study sought to retrospectively evaluate whether combined 18 F-FDG PET/CT with thoracic contrast-enhanced CT (CECT) helps in assessing primary cardiac tumors in adult patients, compared with CECT or PET/CT alone. Methods Forty-six consecutive patients who were diagnosed as primary cardiac tumors were enrolled. All patients underwent 18 F-FDG PET/CT followed by thoracic CECT before biopsy or surgery. Visual qualitative interpretation and quantitative analysis were performed, and diagnostic performance was evaluated. Results More than half (16/29) of benign tumors exhibited with mild 18 F-FDG uptake. There were significant differences in 18 F-FDG uptake and the degree of absolute enhancement between benign and malignant tumors ( P < 0.001). The combination of two modalities improved the specificity from 79 to 93%, the positive predictive value from 73 to 89%, and the accuracy of diagnosis from 85 to 93%. There were significant differences between PET/CT alone or thoracic CECT alone and combined modalities ( P = 0.034 and P = 0.026, respectively). The combination with the optimal SUVmax cutoff value generated 94% sensitivity, 100% specificity, 97% negative predictive values, 100% positive predictive values, and 98% accuracy rates. Conclusions Combining 18 F-FDG PET/C with thoracic CECT significantly improved specificity and accuracy compared to CECT or PET/CT alone in detecting tumors. This combination of diagnostic imaging is effective in differentiating malignant from benign masses.