Bridging imaging and histopathology in cardiac benign tumors: the role of quantitative MRI
T Zheng, L M LuAbstract
Background
The application of parametric mapping as a standard cardiovascular magnetic resonance (CMR) sequence in cardiac tumors remains underexplored.
Purpose
To assess the additional value of CMR parametric mapping in characterizing benign cardiac tumors and differentiating tumor subtypes.
Methods
This retrospective study included patients underwent CMR (with parametric mapping sequences) before surgical resection of suspected cardiac tumors between January 2019 and December 2024. The postoperative pathology was the criterion for determining benign tumor subtype. The parametric mapping such as native T1, post T1, and extracellular volume (ECV) values were measured for tumors. Differences in parametric mapping between tumor subtypes were analyzed using analysis of variance (ANOVA) and Brown-Forsythe test.
Results
Eventually 64 pathologically confirmed benign cardiac tumors (mean age: 36.7 ± 25.3 years; 37 males, 27 females) were included. The native T1 mapping and ECV values were statistically significant in Brown-Forsythe test and ANOVA among different tumor types (p=0.016 and p < 0.01), while no statistically significant difference was found in post T1 mapping values between groups (p = 0.319). The native T1 mapping values ranged from 150 ms (epidermoid cyst) to 1730 ms (hemangioma). The mean ECVs of myxomas, fibromas, hemangiomas, lipomas, rhabdomyomas, schwannomas, epidermoid cyst and angioleiomyolipoma were 51%, 91%, 62%, 5%, 44%, 67%, 52% and 16%, respectively.
Conclusion
CMR parametric mapping, particularly ECV, enables differentiation of benign cardiac tumors with high reproducibility. These findings support the additional role of quantitative CMR techniques to traditional CMR to improve tumor characterization and clinical decision making.ECV for benign cardiac tumorsThe flowchart for the clinical application