Purpose

Correct diagnosis and prognostic assessment of cardiac masses are crucial before therapy. We evaluated the diagnostic and prognostic value of ¹⁸F-FDG PET/CT in patients with cardiac masses.

Methods

¹⁸F-FDG PET/CT images of 64 patients with 65 cardiac masses were retrospectively analysed (34 men, 30 women; average age, 51.2 ± 17.5 years). Comparisons of CT features and ¹⁸F-FDG metabolic indices between benign and malignant entities, as well as among primary and secondary malignancies and lymphoma, were performed. The diagnostic values of PET/CT for distinguishing benign versus malignant masses were calculated. PET/CT data were further assessed for the predictive value for overall survival (OS) using the Cox proportional hazards model to assess potential independent predictors. Kaplan-Meier curves were generated to assess the value of PET/CT for prognostication.

Results

Statistically significant differences in various morphological features and metabolic indices between benign and malignant masses were found. An SUV_max of 6.75 was the optimal cutoff value to differentiate between benign and malignant masses, and the diagnostic sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 92.11%, 88.89%, 90.77%, 92.11%, and 88.89%, respectively. Taking CT features and SUV_max ≥ 6.75 as a criterion, the values were 76.32%, 100.00%, 86.15%, 100.00%, and 75.00%, respectively; taking ≥ 3 CT features or SUV_max ≥ 6.75 as a criterion, the values were 94.74%, 88.89%, 92.31%, 92.31%, and 92.31%, respectively, indicating optimal diagnostic performance when paired with the anatomic information provided by the CT component. A univariate analysis of OS determined that surrounding tissue infiltration, epicardial infiltration, necrosis, multiple chambers or vessel involvement, distant metastasis, SUV_max, SUV_mean, metabolic tumour volume (MTV), and total lesion glycolysis (TLG) were significant predictors of survival. In the multivariate analysis, only SUV_max ≥ 6.715 was significant (P < 0.01). Median OS was 1460 days for SUV_max < 6.715 and 342 days for SUV_max ≥ 6.715 (P < 0.01).

Conclusion

¹⁸F-FDG PET/CT is helpful in the diagnosis of cardiac masses before treatment and has value in detecting extracardiac primary or secondary tumours. ¹⁸F-FDG PET/CT could also be a promising tool to provide prognostic information for these patients, especially SUV_max displaying independent prognostic value.

中文翻译：

---

18 F-FDG PET / CT对心脏包块患者的诊断和预后评估：一项回顾性研究

目的

在治疗前正确诊断和评估心脏质量至关重要。我们评估了¹⁸ F-FDG PET / CT在心脏包块患者中的诊断和预后价值。

方法

回顾性分析了64例心脏质量为65例患者的¹⁸幅F-FDG PET / CT图像（男34例，女30例；平均年龄51.2±17.5岁）。进行了良性和恶性实体之间以及原发和继发性恶性肿瘤与淋巴瘤之间的CT特征和¹⁸ F-FDG代谢指数的比较。计算了PET / CT鉴别良恶性肿块的诊断值。使用Cox比例风险模型评估潜在的独立预测因素，进一步评估PET / CT数据对总体生存（OS）的预测价值。产生Kaplan-Meier曲线以评估PET / CT对预后的价值。

结果

在良性和恶性肿块之间，在各种形态特征和代谢指标上存在统计学上的显着差异。SUV _max为6.75是区分良恶性肿块的最佳临界值，诊断灵敏度，特异性，准确性，阳性预测值和阴性预测值分别为92.11％，88.89％，90.77％，92.11％和88.89。 ％， 分别。以CT设有和SUV_最大值≥6.75为准则，该值分别为76.32％，100.00％，86.15％，100.00％和75.00％; 具有≥3个CT功能或_最大SUV≥6.75作为标准，该值分别为94.74％，88.89％，92.31％，92.31％和92.31％，表明当与CT组件提供的解剖学信息配对时具有最佳的诊断性能。OS的单因素分析确定周围组织浸润，心外膜浸润，坏死，多个腔或血管受累，远处转移，SUV _max，SUV_平均，代谢肿瘤体积（MTV）和总病变糖酵解（TLG）是重要的生存预测指标。在多变量分析中，只有SUV_最大值≥6.715是显著（P  <0.01）。位OS为1460天为SUV_最大<6.715和342天的SUV_最大值≥6.715（P <0.01）。

结论

¹⁸ F-FDG PET / CT在治疗前有助于诊断心脏肿块，并在检测心脏外原发性或继发性肿瘤方面具有价值。¹⁸ F-FDG PET / CT也可能是为这些患者提供预后信息的有前途的工具，尤其是SUV _max具有独立的预后价值。