Diagnostic Accuracy of an Integrated Multimodality Imaging Approach in Patients With Cardiac Masses
Key result
F-FDG PET achieves 0.92 AUC for malignant cardiac masses, improving classification after CMR or CCT.
- AUC 0.92
Why the study?
Does F-FDG PET accurately identify malignant cardiac masses compared to histology?
Key Points
- This research aims to evaluate the diagnostic accuracy of F-FDG PET in identifying malignant cardiac masses, using histology as the gold standard.
- Used F-FDG PET within 2 months of initial medical contact, comparing with histology and radiological resolution for thrombi.
- Assessed diagnostic performance via receiver-operating characteristic curves and performed CART analysis for incremental value evaluation.
- F-FDG PET achieved an AUC of 0.92 for diagnostic accuracy.
- The addition of PET improved diagnostic classification after CMR or CCT in selected cases, confirmed by CART analysis.
Study Design
Type
Observational
Structured PICO
Does F-FDG PET accurately identify malignant cardiac masses compared to histology?
P
Population
Patients with cardiac masses (CMs) undergoing imaging within 2 months of first medical contact
I
Intervention
F-FDG PET imaging (individually and in combination with CMR or CCT)
C
Comparator
Histology or radiological resolution after anticoagulation therapy for thrombi (reference standard)
O
Outcome
Diagnostic accuracy for identifying malignant cardiac masses (measured by AUC)surrogate
Main Result
Effect estimate: AUC 0.92
F-FDG PET demonstrates high diagnostic accuracy (AUC 0.92) for identifying malignant cardiac masses and provides incremental value when added to CMR or CCT.
Implication
May support multimodality strategies for cardiac masses; hypothesis-generating and requires prospective validation before practice change.
Abstract
BACKGROUND: F-FDG) positron emission tomography (PET) remains incompletely defined. OBJECTIVES: F-FDG PET, individually and in combination, for identifying malignant CMs using histology as the reference standard. METHODS: F-FDG PET within 2 months of first medical contact. Final diagnosis was established by histology or radiological resolution after anticoagulation therapy for thrombi. Diagnostic performance was assessed using receiver-operating characteristic curves, and the areas under the curve (AUCs) were compared with the DeLong test, applying Bonferroni correction for multiple comparisons. CART (Classification And Regression Tree) analysis assessed the incremental value of PET following CMR or CCT. RESULTS: F-FDG PET achieved an AUC of 0.92. The addition of PET after CMR or CCT was associated with improved diagnostic classification in selected cases, as supported by CART analysis. CONCLUSIONS: F-FDG PET represents a reliable alternative.
JACC Imaging · cohort study. F-FDG PET after CMR or CCT improved classification of selected cardiac masses. Diagnostic Accuracy of an Integrated Multimodality Imaging Approach in Patients With Cardiac Masses Can F-FDG PET accurately identify malignant cardiac masses? Each imaging read checked against the reference standard: F-FDG PET vs Histology or thrombus resolution. 0.92 AUC: PET accuracy for malignant cardiac masses. Stepwise imaging, confirmed by CART analysis: CMR or CCT first → Add F-FDG PET → Better classification, selected cases. Bottom line: Hypothesis-generating support for multimodality imaging; needs prospective validation. Read the evidence and every expert take. synapsesocial.com/papers/6a1295bf48a0ea1665672040
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Cite This Study
Angeli et al. (2026) conducted an observational in Cardiac Masses. F-FDG PET vs. Histology or radiological resolution was evaluated on Identifying malignant cardiac masses (AUC 0.92). F-FDG PET achieved an AUC of 0.92 for identifying malignant cardiac masses, and its addition after CMR or CCT improved diagnostic classification.