Scope of PET imaging in the evaluation of cardiac tumors

Cardiac and pericardial masses can be categorized as neoplastic (either benign or malignant), non-neoplastic (such as thrombus or pericardial cysts), or normal variants of the cardiac structure. Diagnosing these masses can be challenging, and various imaging modalities are available, with each of them having advantages and pitfalls. Echocardiography is typically the first test used for the evaluation and detection of cardiac masses, as it is widely accessible, portable, and provides a comprehensive assessment of cardiac function and valves without the use of ionizing radiation. However, it may not be helpful in some cases, such as evaluating the extracardiac extension of the mass or characterizing tissue. On the other hand, cross-sectional imaging can provide a three-dimensional data set with excellent spatial resolution. Still, it requires ionizing radiation and intravenous iodinated contrast, and its functional evaluation of the heart may be relatively limited. 18F-FDG PET/CT helps determine 18F-FDG PET/CT is a crucial molecular imaging modality to assess and differentiate benign and malignant cardiac tumors noninvasively and helps in treatment planning and prognostication. Currently, studies evaluating the role of 18F-FDG PET/CT in cardiac tumors are limited to case reports and single center studies.