[Cardiac masses: classification, clinical features and diagnostic approach]

Area of Science:

• Cardiology
• Medical Imaging
• Oncology

Background:

• Cardiac masses encompass tumors, metastases, and pseudotumors like thrombi and vegetations.
• While primary cardiac tumors are rare, secondary masses and pseudotumors are more common.
• A standardized non-invasive diagnostic pathway for cardiac masses is not well-established.

Purpose of the Study:

• To review non-invasive diagnostic techniques for cardiac masses.
• To discuss the capabilities and limitations of each imaging modality.
• To propose a practical diagnostic algorithm for clinical use.

Main Methods:

• Literature review of non-invasive diagnostic techniques for cardiac masses.
• Analysis of echocardiography, cardiac computed tomography (CT), cardiac magnetic resonance (CMR), and positron emission tomography-CT (PET-CT).
• Evaluation of diagnostic accuracy and tissue characterization for various cardiac masses.

Main Results:

• Echocardiography is effective for identifying thrombi, vegetations, and some tumors (e.g., myxoma, fibroelastoma).
• Advanced imaging (CT, CMR) offers better tissue characterization and malignancy assessment.
• A comprehensive non-invasive approach can potentially diagnose malignancy without histology, guiding therapy.

Conclusions:

• A stepwise diagnostic approach utilizing multiple non-invasive imaging modalities is crucial for cardiac masses.
• Advanced imaging techniques like CT and CMR are essential for characterizing masses and assessing malignancy.
• Establishing a clear diagnostic pathway improves patient management and therapeutic strategies for cardiac masses.