948 MULTIMODALITY IMAGING IN CARDIAC MASSES

Abstract Background Cardiac masses (CM) are an extremely heterogeneous clinical scenario, including benign and malignant neoformations. After a first echocardiographic assessment, Computed Tomography (CCT) together with Magnetic Resonance (CMR) 18-Fluorodeoxyglucose Positron Emission (18-FDG-PET) represent second-line third-line imaging techniques to determine the nature of mass. However, data regarding their diagnostic performance standardized algorithm lacking. Purpose To evaluate different roles CCT, CMR, PET in defining CMs propose evidence-based, stepwise, approach. Materials methods Out 312 patients suspected mass from January 2000 August 2022, we enrolled 87 who underwent CMR 18-FDG-PET within month initial evaluation. A definitive diagnosis was achieved by histological examination or, case cardiac thrombi, radiological evidence thrombus resolution after appropriate anticoagulant treatment. For each technique, identified model strongest predictors malignancy at multivariate analysis evaluated ability discriminate between multiple forwarding selection performed identify 18-FDG-PET. Results CCT included 4 variables (irregular margins, dimension, invasiveness not-hypodense lesion) Area Under Curve (AUC) 0.972, 95% Confidence Interval (CI) 0.94-1.0; 3 parameters (invasiveness, pericardial effusion irregular AUC 0.976 CI 0.95-1.0); only maximum Standardized Uptake Value (SUVmax), 0.87 (95% IC 0.74-0.971). When implemented SUVmax, models showed slight improvement discrimination (AUC 0.975 0.986, respectively). No statistical difference observed 0.972 vs 0.976, p=0.26). on evaluating variables, MR remained significant malignancy. Conclusion application may be most accurate second-level investigation lesions. is not available, or patient has contraindications performs similarly, provides negligible advantage.