Skip to main content

Other Imaging Techniques: Computed Tomography and Positron Emission Tomography

  • Chapter
  • First Online:
Manual of Cardio-oncology

Abstract

Both computed tomography (CT) and positron emission tomography (PET) may be useful in addition to echocardiography and magnetic resonance (MR) imaging to study cardiac tumors. CT scan may be used as an alternative imaging modality in patients who cannot undergo MR because it is contraindicated or in patients already examined with other noninvasive methods without obtaining adequate images. High-speed equipments with electrocardiographic (ECG) gating can provide images with resolution <1 mm; multiplanar and tridimensional reconstructions are also possible. PET is based on the detection of metabolic activity after injection of radionuclides. The most commonly used tracing in oncology is fluorodeoxyglucose (18F-FDG), which concentrates in tissue with high glucose metabolism. PET is usually performed together with computed tomography (PET/CT). To quantify the glucose metabolism, the maximum standardized uptake value (SUV) is used. Malignant tumors have usually a high SUV, which may increase with the proliferative index. Some other organs, such as the liver and heart, may have variable uptake according to different metabolic conditions. The myocardial 18FDG uptake may vary widely between different patients and – in the same patient – between different exams. In order to improve the accuracy of 18FDG-PET in cardiac tumor imaging, a carbohydrate- poor and fat-rich meal followed by a fasting period of 12–18 h is suggested before the exam.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Buckley O, Madan R, Kwong R, et al. Cardiac masses, part 1: imaging strategies and technical considerations. AJR Am J Roentgenol. 2011;197:W837–41.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Chu LC, Johnson PT, Halushka MK, Fishman EK. Multidetector CT of the heart: spectrum of benign and malignant cardiac masses. Emerg Radiol. 2012;19:415–28.

    Article  PubMed  Google Scholar 

  3. Rajiah P, Kanne JP, Kalahasti V, Schoenhagen P. Computed tomography of cardiac and pericardiac masses. J Cardiovasc Comput Tomogr. 2011;5:16–29.

    Article  PubMed  Google Scholar 

  4. Kassop D, Donovan MS, Cheezum MK, et al. Cardiac masses on cardiac CT: a review. Curr Cardiovasc Imaging Rep. 2014;7:9281. Review.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Hoey E, Ganeshan A, Nader K, et al. Cardiac neoplasms and pseudotumors: imaging findings on multidetector CT angiography. Diagn Interv Radiol. 2012;18:67–77.

    PubMed  Google Scholar 

  6. Tokmak H, Demir N, Demirkol MO. Cardiac angiosarcoma: utility of [(18)F]fluorodeoxyglucose positron emission tomography-computed tomography in evaluation of residue, metastases, and treatment response. Vasc Health Risk Manag. 2014;10:399–401.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Maurer AH, Burshteyn M, Adler LP, Steiner RM. How to differentiate benign versus malignant cardiac and paracardiac 18F FDG uptake at oncologic PET/CT. Radiographics. 2011;31:1287–305.

    Article  PubMed  Google Scholar 

  8. Rahbar K, Seifarth H, Schäfers M, et al. Differentiation of malignant and benign cardiac tumors using 18F-FDG PET/CT. J Nucl Med. 2012;53:856–63.

    Article  CAS  PubMed  Google Scholar 

  9. Benz MR, Dry SM, Eilber FC, Allen-Auerbach MS, Tap WD, Elashoff D, Phelps ME, Czernin J. Correlation between glycolytic phenotype and tumor grade in soft-tissue sarcomas by 18F-FDG PET. J Nucl Med. 2010;51:1174–81.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Korn RL, Coates A, Millstine J. The role of glucose and FDG metabolism in the interpretation of PET studies. In: Lin EC, Alavi A, editors. PET and PET/CT. A clinical guide. 2nd ed. New York: Thieme; 2009.

    Google Scholar 

  11. Lin EC, Alavi A. Normal variants and benign findings. In: Lin EC, Alavi A, editors. PET and PET/CT. A clinical guide. 2nd ed. New York: Thieme; 2009.

    Google Scholar 

  12. Watanabe R, Tomita N, Takeuchi K, et al. SUVmax in FDG-PET and the biopsy site correlates with the proliferation potential of tumor cells in non-Hodgkin lymphoma. Leuk Lymphoma. 2010;51:279–83.

    Article  PubMed  Google Scholar 

  13. Kobayashi Y, Kumita S, Fukushima Y, et al. Significant suppression of myocardial (18)F-fluorodeoxyglucose uptake using 24-h carbohydrate restriction and a low-carbohydrate, high-fat diet. J Cardiol. 2013;62:314–9.

    Article  PubMed  Google Scholar 

  14. Manabe O, Yoshinaga K, Ohira H, et al. The effects of 18-h fasting with low-carbohydrate diet preparation on suppressed physiological myocardial (18)F-fluorodeoxyglucose (FDG) uptake and possible minimal effects of unfractionated heparin use in patients with suspected cardiac involvement sarcoidosis. J Nucl Cardiol. 2015 Aug 5.

    Google Scholar 

  15. Masuda A, Naya M, Manabe O, et al. Administration of unfractionated heparin with prolonged fasting could reduce physiological 18F-fluorodeoxyglucose uptake in the heart. Acta Radiol. 2015 Sep.

    Google Scholar 

  16. Loft A, Jensen KE, Löfgren J, Daugaard S, Petersen MM. PET/MRI for Preoperative Planning in Patients with Soft Tissue Sarcoma: A Technical Report of Two Patients. Case Rep Med. 2013;2013, 791078.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Nensa F, Beiderwellen K, Heusch P, Wetter A. Clinical applications of PET/MRI: current status and future perspectives. Diagn Interv Radiol. 2014;20:438–47.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Tanja Baresic .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Urbani, M., Borsatti, E., Baresic, T. (2017). Other Imaging Techniques: Computed Tomography and Positron Emission Tomography. In: Lestuzzi, C., Oliva, S., Ferraù, F. (eds) Manual of Cardio-oncology. Springer, Cham. https://doi.org/10.1007/978-3-319-40236-9_23

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-40236-9_23

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-40234-5

  • Online ISBN: 978-3-319-40236-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics