TY - JOUR
T1 - PET/CT morphology and cardiac conduction disorders help discriminate primary cardiac lymphoma from primary cardiac sarcoma
AU - Yuan, Hui
AU - Qiu, Jia
AU - Chiu, Keith W.H.
AU - Chan, Lawrence W.C.
AU - Zhang, Fen
AU - Wei, Xiaojuan
AU - Jiang, Lei
N1 - Funding Information:
This work was supported by the fund from the National Natural Science Foundation of China (81971645) and Guangdong Provincial People's Hospital (KY0120211130).
Funding Information:
This work was supported by the fund from the National Natural Science Foundation of China (81971645) and Guangdong Provincial People's Hospital (KY0120211130). LJ, XW, HY, and JQ designed the study. Data collection was performed by HY, JQ, and XW, while data curation was performed by HY, QJ, XW, and FZ. Data analysis was performed by HY and LWCC, of which LWCC is the certified statistician who suggested and supervised all statistical analyses utilized in this study. The manuscript was written and edited by HY, LJ, and KWHC. All authors read and approved the final manuscript. Hui Yuan, Jia Qiu, Keith W. H. Chiu, Lawrence W. C. Chan, Fen Zhang, Xiaojuan Wei, and Lei Jiang declare that they have no conflict of interest. All procedures performed in studies involving human participants were approved by the Ethics Committee at Guangdong Provincial People's Hospital, and with the principles of the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
Publisher Copyright:
© 2022, The Author(s) under exclusive licence to American Society of Nuclear Cardiology.
PY - 2022/12
Y1 - 2022/12
N2 - Background: Primary cardiac lymphoma (PCL) and primary cardiac sarcoma (PCS) are similar in clinical presentation but differ in management and outcomes. We aim to explore the role of PET morphology and clinical characteristics in distinguishing PCL from PCS. Methods: Pretreatment 18F-FDG PET/CT and contrast-enhanced CT were performed in PCL (n = 14) and PCS (n = 15) patients. Patient demographics, overall survival, and progression-free survival were reviewed. PET/CT morphological and metabolic features were extracted. Specifically, R_Kurtosis, a PET-morphology parameter reflecting the tumor expansion within the heart, was calculated. Results: Compared with PCS, PCL occurred at an older age, resulted in more cardiac dysfunctions and arrhythmias, and showed higher glucometabolism (SUVmax, SUVpeak, SUVmean, MTV, and TLG). Curative treatments improved survival for PCL but not for PCS. Multivariable logistic regression identified R_Kurtosis (OR = 27.025, P =.007) and cardiac conduction disorders (OR = 37.732, P =.016) independently predictive of PCL, and classification and regression tree analysis stratified patients into three subgroups: R_Kurtosis ≥ 0.044 (probability of PCL 88.9%), R_Kurtosis < 0.044 with conduction disorders (80.0%), and R_Kurtosis < 0.044 without conduction disorders (13.3%). Conclusion: PET-derived tumor expansion pattern (R_Kurtosis) and cardiac conduction disorders were helpful in distinguishing PCL from PCS, which might assist the clinical management.
AB - Background: Primary cardiac lymphoma (PCL) and primary cardiac sarcoma (PCS) are similar in clinical presentation but differ in management and outcomes. We aim to explore the role of PET morphology and clinical characteristics in distinguishing PCL from PCS. Methods: Pretreatment 18F-FDG PET/CT and contrast-enhanced CT were performed in PCL (n = 14) and PCS (n = 15) patients. Patient demographics, overall survival, and progression-free survival were reviewed. PET/CT morphological and metabolic features were extracted. Specifically, R_Kurtosis, a PET-morphology parameter reflecting the tumor expansion within the heart, was calculated. Results: Compared with PCS, PCL occurred at an older age, resulted in more cardiac dysfunctions and arrhythmias, and showed higher glucometabolism (SUVmax, SUVpeak, SUVmean, MTV, and TLG). Curative treatments improved survival for PCL but not for PCS. Multivariable logistic regression identified R_Kurtosis (OR = 27.025, P =.007) and cardiac conduction disorders (OR = 37.732, P =.016) independently predictive of PCL, and classification and regression tree analysis stratified patients into three subgroups: R_Kurtosis ≥ 0.044 (probability of PCL 88.9%), R_Kurtosis < 0.044 with conduction disorders (80.0%), and R_Kurtosis < 0.044 without conduction disorders (13.3%). Conclusion: PET-derived tumor expansion pattern (R_Kurtosis) and cardiac conduction disorders were helpful in distinguishing PCL from PCS, which might assist the clinical management.
KW - cardiac conduction disorders
KW - morphology
KW - PET
KW - Primary cardiac lymphoma (PCL)
KW - primary cardiac sarcomas (PCS)
UR - http://www.scopus.com/inward/record.url?scp=85133500372&partnerID=8YFLogxK
U2 - 10.1007/s12350-022-03042-0
DO - 10.1007/s12350-022-03042-0
M3 - Journal article
C2 - 35790691
AN - SCOPUS:85133500372
SN - 1071-3581
VL - 29
SP - 2866
EP - 2877
JO - Journal of Nuclear Cardiology
JF - Journal of Nuclear Cardiology
IS - 6
ER -