Key result
Quantitative contrast echocardiography accurately identifies malignant cardiac tumors with ~0.95 AUC.
Why the study?
Conventional transthoracic echocardiography has limitations in accurately characterizing cardiac masses, particularly in differentiating benign from malignant tumors, necessitating improved diagnostic techniques.
Does quantitative contrast echocardiography improve the diagnostic accuracy of cardiac masses in adult patients?
Cohort (n=145)
Yes
Does quantitative contrast echocardiography improve the diagnostic accuracy of cardiac masses in adult patients?
Quantitative contrast echocardiography offers a highly accurate and accessible method for differentiating cardiac tumors from thrombi and distinguishing malignant from benign lesions.
A 64-year-old man with chronic liver disease presented with dyspnoea, and a chest contrast computed tomography (CT) was performed to evaluate the suspect of pulmonary embolism (Panel A). A mass occupying the right atrium, of the same density of the myocardium at early-phase scan, was diagnosed as thrombus by CT findings. Echocardiography (Panel B) was performed with a continuous infusion of contrast and flash-replenishment assessment to dynamically evaluate whether the mass was filled by microbubbles (an intravascular tracer), vascularization raising the possibility of malignancy. The mass filled with contrast at a similar rate compared with the myocardium (Panel B, lower panel, Supplementary material online, Video S1) confirming vascularization. [18]FDG positron emission tomography showed hyperaccumulation of the radioactive marker in the right atrium and liver (Panels C and D), confirming the malignancy. The general conditions quickly worsened and the patient died. The autopsy confirmed liver lesions and the 8 × 7 × 4 cm right atrium lesion (Panel E). The histopathology of both the liver (Panel F, upper) and atrial (Panel F, lower) lesions showed features of poorly differentiated adenocarcinoma; haematoxylin–eosin staining (left) and immunohistochemistry positivity for Citytocheratin 7 (mid) and cytoplasmic pCEA (right) were consistent for cholangiocarcinoma, rather than hepatocellular carcinoma. Supplementary material is available at European Heart Journal online.
No takes yet. Share an insight, caveat, or question.
Gaibazzi et al. (2013) conducted a cohort in Suspected cardiac masses (n=145). Contrast echocardiography (CE) vs. Reference standard (pathological diagnosis, cardiac magnetic resonance, or clinical follow-up) was evaluated on Diagnostic accuracy (AUC) of A1/A2 peak intensity ratio for differentiating malignant from benign cardiac tumors (AUC 0.950, 95% CI 0.894-1.000). Quantitative contrast echocardiography accurately differentiated malignant from benign cardiac tumors using an A1/A2 peak intensity ratio cut-off of 1.58, yielding an AUC of 0.950.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: