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In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
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Incremental Diagnostic Value of Computed Tomography Attenuation in Differentiating Malignant Pericardial Effusion: A

Duygu İnan1, Ayse İrem Demirtola Mammadli2, Gamze Gençol Akçay1

  • 1Department of Cardiology, Başakşehir Çam and Sakura City Hospital, İstanbul, Türkiye.

Turk Kardiyoloji Dernegi Arsivi : Turk Kardiyoloji Derneginin Yayin Organidir
|July 4, 2025
PubMed

Insights

Computed tomography (CT) attenuation can help identify malignant pericardial effusion (MPE) when combined with clinical data. This non-invasive method improves diagnostic accuracy for MPE, aiding early detection.

Area of Science:

  • Cardiology
  • Radiology
  • Oncology

Background:

  • Malignant pericardial effusion (MPE) is linked to poor prognosis and often presents as cardiac tamponade.
  • Cytology, the current diagnostic standard for MPE, has limited sensitivity.
  • Computed tomography (CT) attenuation values may indicate fluid composition, aiding non-invasive MPE differentiation.

Purpose of the Study:

  • To evaluate the diagnostic performance of CT attenuation in differentiating malignant from non-malignant pericardial effusion.
  • To compare the diagnostic accuracy of a model incorporating CT attenuation with a model using only clinical and laboratory variables.

Main Methods:

  • Retrospective single-center study of 102 patients undergoing pericardiocentesis and thoracic CT.
  • Malignant and non-malignant effusions classified by pathological findings.
  • CT attenuation measured at standardized axial levels; diagnostic performance assessed via logistic regression and ROC analysis.

Main Results:

  • MPE diagnosed in 43.1% of patients; CT attenuation was significantly higher in the MPE group (24.4 HU vs. 9.3 HU).
  • CT attenuation, along with male sex, elevated fluid protein, low glucose, and high lactate dehydrogenase, independently predicted MPE.
  • The model including CT attenuation (Model 2) showed improved diagnostic performance (AUC: 0.893) compared to clinical/lab variables alone (Model 1, AUC: 0.860).

Conclusions:

  • CT attenuation offers incremental diagnostic value for MPE when integrated with clinical and biochemical parameters.
  • The non-invasive and reproducible nature of CT attenuation supports early detection of malignant conditions, particularly when rapid diagnosis is crucial.
Abstract

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