title: MR first pass perfusion of benign and malignant cardiac tumours-significant differences and diagnostic accuracy.
abstract: OBJECTIVE
  To determine the diagnostic value of magnetic resonance (MR) first pass perfusion in the differentiation of benign and malignant cardiac tumours.
  
  
  METHODS
  24 patients with cardiac tumours (11 malignant, histopathological correlation present in all cases) were examined using MRI. In addition to morphological sequences a saturation-recovery T1w-GRE technique was implemented for tumour perfusion. The maximum relative signal enhancement (RSE[%]) and the slope of the RSE(t)-curve (slopeRSE[%/s]) of tumour tissue were assessed. A t-test was used to identify significant differences between benign and malignant tumours. Sensitivities and specificities were calculated for detection of malignant lesions and were compared with the sensitivity and specificity based on solely morphological image assessment.
  
  
  RESULTS
  The RSE and slopeRSE of malignant cardiac tumours were significantly higher compared with benign lesions (p < 0.001 and p < 0.001). The calculated sensitivities and specificities of RSE and slopeRSE for identification of malignant lesions were 100% and 84.6% and 100% and 92.3%, respectively with cut-off values of 80% and 6%/s. The sensitivity and specificity for identification of malignant lesions on the basis of morphological imaging alone were 90.9% and 69.2%.
  
  
  CONCLUSIONS
  With first pass perfusion, malignant cardiac masses can be identified with higher sensitivity and specificity compared with morphological image assessment alone.
authors.affiliation: Department of Clinical Radiology, University Hospitals Grosshadern, Ludwig-Maximilians-University of Munich, Marchioninistr. 15, 81377 Munich, Germany. kerstin.bauner@med.uni-muenchen.de
authors.forename: K U
authors.initials: KU
authors.lastname: Bauner
authors.forename: S
authors.initials: S
authors.lastname: Sourbron
authors.forename: M
authors.initials: M
authors.lastname: Picciolo
authors.forename: C
authors.initials: C
authors.lastname: Schmitz
authors.forename: D
authors.initials: D
authors.lastname: Theisen
authors.forename: T A
authors.initials: TA
authors.lastname: Sandner
authors.forename: M F
authors.initials: MF
authors.lastname: Reiser
authors.forename: A M
authors.initials: AM
authors.lastname: Huber
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006338:Heart Neoplasms / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D007089:Image Enhancement; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods / Q000592:standards; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D003287:Contrast Media