Arq Bras Cardiol: Imagem cardiovasc. 2024; 37(2): e20240040
My Approach to Evaluation of Cardiac Masses Using FDG PET/CT
DOI: 10.36660/abcimg.20240040i
Abstract
Cardiac masses represent solid formations of various origins, with accurate diagnosis being crucial, particularly for those of a malignant nature, which are typically associated with a worse prognosis. Given this diversity, a comprehensive approach often involves the integration of multiple imaging modalities. Conventional cardiovascular imaging techniques such as transthoracic echocardiography, magnetic resonance imaging (MRI), and cardiac tomography offer insights into anatomical features and hemodynamic implications associated with these masses. However, due to its limitations, greater precision in the etiological investigation of these masses can be achieved by combining Nuclear Medicine with complementary methods, notably positron emission tomography combined with computed tomography using fluorodeoxyglucose-Fluorine-18 (FDG PET/CT). This approach aids in effectively assessing cardiac masses’ metabolic activity, particularly when distinguishing between benign and malignant masses, guiding optimal biopsy site selection, and facilitating comprehensive staging. The Standardized Uptake Value (SUVmax) serves as a quantitative measure of FDG uptake by the mass, with elevated SUVmax values indicating malignancy. Clinical and conventional imaging data should complement the interpretation of FDG PET/CT findings for a more conclusive diagnosis. Thus, a multimodal strategy, particularly incorporating FDG PET/CT, enables a more precise differentiation between benign and malignant cardiac masses, ultimately optimizing patient management.
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