Utility of FDG PETCT in assessment of cardiac masses

Objectives Cardiac masses though uncommon are a cause of major concern due to associated morbidity and mortality. They can be benign or malignant. There is limited information in the literature about the role of FDG PET in the evaluation of cardiac masses. The aim of this study was to analyze the utility of FDG PETCT in assessment of cardiac masses.

Methods This retrospective study involved 18 patients (7 males, 11 females, age range 20-63 years) who underwent PETCT for evaluation of cardiac masses. PET findings were correlated with histology, cardiac CT/ MR imaging and clinical follow up. Lesions were considered PET positive if the FDG uptake was greater than the mediastinal blood pool uptake.

Results Of the 18 cases, 11 were PET positive (61%) and 7 PET negative (39%). Among the 7 PET negative cases all 7 were found to be benign on follow up (100%). Of the 11 PET positive cases 8 proved to be malignant (72%). The malignant cases included sarcoma 3, metastasis 4 , and paraganglioma 1. Three PET positive cases which were found to be benign included 1 case each of sarcoid, thrombus and vasculitis. The mean of Maximum SUV of the malignant cases was 8.1 where as 1.9 for the benign cases.

Conclusions FDG-PETCT is a useful noninvasive tool to assess cardiac masses. A negative FDG PET is an excellent predictor of benign nature. Most of the PET positive cases were malignant. Inflammatory cardiovascular pathologies such as sarcoid and vasculitis can be FDG PET positive