TY - JOUR
T1 - Accuracy of Cardiac Magnetic Resonance Imaging in Diagnosing Pediatric Cardiac Masses
T2 - A Multicenter Study
AU - Beroukhim, Rebecca S
AU - Ghelani, Sunil
AU - Ashwath, Ravi
AU - Balasubramanian, Sowmya
AU - Biko, David M
AU - Buddhe, Sujatha
AU - Campbell, M Jay
AU - Cross, Russell
AU - Festa, Pierluigi
AU - Griffin, Lindsay
AU - Grotenhuis, Heynric
AU - Hasbani, Keren
AU - Hashemi, Sassan
AU - Hegde, Sanjeet
AU - Hussain, Tarique
AU - Jain, Supriya
AU - Kiaffas, Maria
AU - Kutty, Shelby
AU - Lam, Christopher Z
AU - Liberato, Gabriela
AU - Merlocco, Anthony
AU - Misra, Nilanjana
AU - Mowers, Katie L
AU - Muniz, Juan Carlos
AU - Nutting, Arni
AU - Parra, David A
AU - Patel, Jyoti K
AU - Perez-Atayde, Antonio R
AU - Prasad, Deepa
AU - Rosental, Carlos F
AU - Shah, Amee
AU - Samyn, Margaret M
AU - Sleeper, Lynn A
AU - Slesnick, Timothy
AU - Valsangiacomo, Emanuela
AU - Geva, Tal
N1 - Funding Information:
The authors acknowledge the following individuals: David Annese, RT(R)(MR), Debi Wilkinson (case submission and processing), and Minmin Lu, MS (figure preparation).
Publisher Copyright:
© 2022
PY - 2022/8
Y1 - 2022/8
N2 - BACKGROUND: After diagnosis of a cardiac mass, clinicians must weigh the benefits and risks of ascertaining a tissue diagnosis. Limited data are available on the accuracy of previously developed noninvasive pediatric cardiac magnetic resonance (CMR)-based diagnostic criteria.OBJECTIVES: The goals of this study were to: 1) evaluate the CMR characteristics of pediatric cardiac masses from a large international cohort; 2) test the accuracy of previously developed CMR-based diagnostic criteria; and 3) expand diagnostic criteria using new information.METHODS: CMR studies (children 0-18 years of age) with confirmatory histological and/or genetic diagnosis were analyzed by 2 reviewers, without knowledge of prior diagnosis. Diagnostic accuracy was graded as: 1) single correct diagnosis; 2) correct diagnosis among a differential; or 3) incorrect diagnosis.RESULTS: Of 213 cases, 174 (82%) had diagnoses that were represented in the previously published diagnostic criteria. In 70% of 174 cases, both reviewers achieved a single correct diagnosis (94% of fibromas, 71% of rhabdomyomas, and 50% of myxomas). When ≤2 differential diagnoses were included, both reviewers reached a correct diagnosis in 86% of cases. Of 29 malignant tumors, both reviewers indicated malignancy as a single diagnosis in 52% of cases. Including ≤2 differential diagnoses, both reviewers indicated malignancy in 83% of cases. Of 6 CMR sequences examined, acquisition of first-pass perfusion and late gadolinium enhancement were independently associated with a higher likelihood of a single correct diagnosis.CONCLUSIONS: CMR of cardiac masses in children leads to an accurate diagnosis in most cases. A comprehensive imaging protocol is associated with higher diagnostic accuracy.
AB - BACKGROUND: After diagnosis of a cardiac mass, clinicians must weigh the benefits and risks of ascertaining a tissue diagnosis. Limited data are available on the accuracy of previously developed noninvasive pediatric cardiac magnetic resonance (CMR)-based diagnostic criteria.OBJECTIVES: The goals of this study were to: 1) evaluate the CMR characteristics of pediatric cardiac masses from a large international cohort; 2) test the accuracy of previously developed CMR-based diagnostic criteria; and 3) expand diagnostic criteria using new information.METHODS: CMR studies (children 0-18 years of age) with confirmatory histological and/or genetic diagnosis were analyzed by 2 reviewers, without knowledge of prior diagnosis. Diagnostic accuracy was graded as: 1) single correct diagnosis; 2) correct diagnosis among a differential; or 3) incorrect diagnosis.RESULTS: Of 213 cases, 174 (82%) had diagnoses that were represented in the previously published diagnostic criteria. In 70% of 174 cases, both reviewers achieved a single correct diagnosis (94% of fibromas, 71% of rhabdomyomas, and 50% of myxomas). When ≤2 differential diagnoses were included, both reviewers reached a correct diagnosis in 86% of cases. Of 29 malignant tumors, both reviewers indicated malignancy as a single diagnosis in 52% of cases. Including ≤2 differential diagnoses, both reviewers indicated malignancy in 83% of cases. Of 6 CMR sequences examined, acquisition of first-pass perfusion and late gadolinium enhancement were independently associated with a higher likelihood of a single correct diagnosis.CONCLUSIONS: CMR of cardiac masses in children leads to an accurate diagnosis in most cases. A comprehensive imaging protocol is associated with higher diagnostic accuracy.
KW - cardiac magnetic resonance
KW - cardiac mass
KW - cardiac tumor
KW - pediatric
UR - https://www.scopus.com/pages/publications/85135596644
U2 - 10.1016/j.jcmg.2021.07.010
DO - 10.1016/j.jcmg.2021.07.010
M3 - Article
C2 - 34419404
SN - 1936-878X
VL - 15
SP - 1391
EP - 1405
JO - JACC. Cardiovascular imaging
JF - JACC. Cardiovascular imaging
IS - 8
ER -