Accuracy of Cardiac Magnetic Resonance Imaging in Diagnosing Pediatric Cardiac Masses: A Multicenter Study.

Journal Article (Journal Article;Multicenter Study)

BACKGROUND: After diagnosis of a cardiac mass, clinicians must weigh the benefits and risks of ascertaining a tissue diagnosis. Limited data are available on the accuracy of previously developed noninvasive pediatric cardiac magnetic resonance (CMR)-based diagnostic criteria. OBJECTIVES: The goals of this study were to: 1) evaluate the CMR characteristics of pediatric cardiac masses from a large international cohort; 2) test the accuracy of previously developed CMR-based diagnostic criteria; and 3) expand diagnostic criteria using new information. METHODS: CMR studies (children 0-18 years of age) with confirmatory histological and/or genetic diagnosis were analyzed by 2 reviewers, without knowledge of prior diagnosis. Diagnostic accuracy was graded as: 1) single correct diagnosis; 2) correct diagnosis among a differential; or 3) incorrect diagnosis. RESULTS: Of 213 cases, 174 (82%) had diagnoses that were represented in the previously published diagnostic criteria. In 70% of 174 cases, both reviewers achieved a single correct diagnosis (94% of fibromas, 71% of rhabdomyomas, and 50% of myxomas). When ≤2 differential diagnoses were included, both reviewers reached a correct diagnosis in 86% of cases. Of 29 malignant tumors, both reviewers indicated malignancy as a single diagnosis in 52% of cases. Including ≤2 differential diagnoses, both reviewers indicated malignancy in 83% of cases. Of 6 CMR sequences examined, acquisition of first-pass perfusion and late gadolinium enhancement were independently associated with a higher likelihood of a single correct diagnosis. CONCLUSIONS: CMR of cardiac masses in children leads to an accurate diagnosis in most cases. A comprehensive imaging protocol is associated with higher diagnostic accuracy.

Full Text

Duke Authors

Cited Authors

  • Beroukhim, RS; Ghelani, S; Ashwath, R; Balasubramanian, S; Biko, DM; Buddhe, S; Campbell, MJ; Cross, R; Festa, P; Griffin, L; Grotenhuis, H; Hasbani, K; Hashemi, S; Hegde, S; Hussain, T; Jain, S; Kiaffas, M; Kutty, S; Lam, CZ; Liberato, G; Merlocco, A; Misra, N; Mowers, KL; Muniz, JC; Nutting, A; Parra, DA; Patel, JK; Perez-Atayde, AR; Prasad, D; Rosental, CF; Shah, A; Samyn, MM; Sleeper, LA; Slesnick, T; Valsangiacomo, E; Geva, T

Published Date

  • August 2022

Published In

Volume / Issue

  • 15 / 8

Start / End Page

  • 1391 - 1405

PubMed ID

  • 34419404

Electronic International Standard Serial Number (EISSN)

  • 1876-7591

Digital Object Identifier (DOI)

  • 10.1016/j.jcmg.2021.07.010


  • eng

Conference Location

  • United States