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World J Cardiol. Jul 26, 2017; 9(7): 600-608
Published online Jul 26, 2017. doi: 10.4330/wjc.v9.i7.600
Cardiac and pericardial tumors: A potential application of positron emission tomography-magnetic resonance imaging
Ahmed Fathala, Mohei Abouzied, Abdul-Aziz AlSugair
Ahmed Fathala, Mohei Abouzied, Abdul-Aziz AlSugair, Department of Radiology, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
Author contributions: All authors contributed equally to this work.
Conflict-of-interest statement: We declare we do not have any conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ahmed Fathala, MD, Consultant Nuclear Medicine and Cardiovascular Imaging, Department of Radiology, King Faisal Specialist Hospital and Research Center, P.O. Box 3354, MBC 28, Riyadh 11211, Saudi Arabia. afathala@kfshrc.edu.sa
Telephone: +966-55-2532402 Fax: +966-11-4424841
Received: December 29, 2016
Peer-review started: December 31, 2016
First decision: March 28, 2017
Revised: April 20, 2017
Accepted: May 12, 2017
Article in press: May 15, 2017
Published online: July 26, 2017
Abstract

Cardiac and pericardial masses may be neoplastic, benign and malignant, non-neoplastic such as thrombus or simple pericardial cysts, or normal variants cardiac structure can also be a diagnostic challenge. Currently, there are several imaging modalities for diagnosis of cardiac masses; each technique has its inherent advantages and disadvantages. Echocardiography, is typically the initial test utilizes in such cases, Echocardiography is considered the test of choice for evaluation and detection of cardiac mass, it is widely available, portable, with no ionizing radiation and provides comprehensive evaluation of cardiac function and valves, however, echocardiography is not very helpful in many cases such as evaluation of extracardiac extension of mass, poor tissue characterization, and it is non diagnostic in some cases. Cross sectional imaging with cardiac computed tomography provides a three dimensional data set with excellent spatial resolution but utilizes ionizing radiation, intravenous iodinated contrast and relatively limited functional evaluation of the heart. Cardiac magnetic resonance imaging (CMR) has excellent contrast resolution that allows superior soft tissue characterization. CMR offers comprehensive evaluation of morphology, function, tissue characterization. The great benefits of CMR make CMR a highly useful tool in the assessment of cardiac masses. (Fluorine 18) fluorodeoxygluocse (FDG) positron emission tomography (PET) has become a corner stone in several oncological application such as tumor staging, restaging, treatment efficiency, FDG is a very useful imaging modality in evaluation of cardiac masses. A recent advance in the imaging technology has been the development of integrated PET-MRI system that utilizes the advantages of PET and MRI in a single examination. FDG PET-MRI provides complementary information on evaluation of cardiac masses. The purpose of this review is to provide several clinical scenarios on the incremental value of PET and MRI in the evaluation of cardiac masses.

Keywords: Cardiac, Pericardial tumors, Echocardiography

Core tip: With the commercial availability of positron emission tomography- magnetic resonance imaging (PET-MRI) true simultaneous PET and MRI in a single study is real. Several studies have demonstrated the feasibility and incremental value of combined PET and MRI in many clinical applications. A combination of PET and MRI can provide incremental information in many cardiovascular scenarios. Evaluation of cardiac tumors may be most straightforward application for PET-MRI because it offers a unique opportunity to evaluate the tumor morphology, characterization, infiltration to adjacent structures, local and M staging and comprehensive cardiac evaluation in a single study. The purpose of this review is to provide several clinical scenarios on the incremental value of PET and MRI in the evaluation of cardiac masses.