Gastroenteropancreatic Neuroendocrine Tumor Metastasis to the Heart: Evaluation of Imaging Manifestations.
Gastroenteropancreatic Neuroendocrine Tumor Metastasis to the Heart: Evaluation of Imaging Manifestations.
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胃肠道神经内分泌肿瘤转移到心脏：成像表现的评估。
DOI：
10.1067/j.cpradiol.2022.11.011
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发表时间：
2023-09
影响因子：
1.4
通讯作者：
Yang, Ming
中科院分区：
文献类型：
--
作者：
Wang, Yuxiang;Ayoub, Chadi;Yang, Aaron F.;Sonbol, Mohamad B.;Butter, Richard;Halfdanarson, Thorvardur R.;Arsanjani, Reza;Zhu, Wuqiang;Yang, Ming
神经内分泌肿瘤（NET）可能通过心脏转移或类癌性心脏病影响心脏。NET转移到心脏是罕见的，有有限的资料表征它。我们试图评估68Ga-DOTATATE PET扫描成像特征和相关的心脏成像特征，如果有NET心脏转移。我们回顾了68Ga-DOTATATE正电子发射断层扫描(PET)/CT扫描对胃肠胰（GEP） NET患者的心脏累及。那些被确定为心脏转移的患者，他们的电子病历、经胸超声心动图（TTE）和心脏磁共振成像（MRI）进行了检查，以确定其特征。在对GEP-NET患者进行的1426次68Ga-DOTATATE PET/CT扫描中，25例（1.75%）的心脏摄取与转移一致。其中22例有心肌转移（29例有明显的心肌病变：左心室16例，右心室6例，室间隔7例），3例仅累及放射状周围淋巴结。除了伴有类癌性心脏病的患者（2/25）外，DOTATATE扫描发现的伴有心脏转移的NET患者似乎没有任何血流动力学上显著的TTE特征。在接受TTE检查的14例患者中，只有1例高转移性心脏肿瘤患者有可检测到的心脏肿块。有MRI检查的6例患者，均有转移性心脏病变，68Ga-DOTATATE PET扫描与肿瘤定位有很好的相关性。68Ga-DOTATATE PET对心脏NET转移具有良好的诊断能力。心脏MRI可以提供进一步的解剖和组织特征评估。无类癌性心脏病的心肌NET转移患者，超声心动图检查无明显血流动力学影响。
Neuroendocrine tumors (NET) may affect the heart by cardiac metastasis or carcinoid heart disease. NET metastasis to the heart is rare, with limited data characterizing it. We sought to evaluate 68Ga-DOTATATE PET scan imaging features and associated cardiac imaging characteristics where available in those with NET cardiac metastases. 68Ga-DOTATATE positron emission tomography (PET)/CT scans performed on patients with gastroenteropancreatic (GEP) NET at our institution were reviewed for cardiac involvement. Those identified with cardiac metastases had their electronic medical record, transthoracic echocardiogram (TTE) and cardiac magnetic resonance imaging (MRI) reviewed for characterization. From a total of 1426 68Ga-DOTATATE PET/CT scans performed on patients with GEP-NET, 25 (1.75%) had cardiac uptake consistent with metastasis. Of these, 22 had myocardial metastases (29 distinct myocardial lesions: left ventricle - 16, right ventricle - 6, and ventricular septum −7) and 3 had periradial lymph node involvement only. NET patients with cardiac metastases as identified by DOTATATE scan did not appear to have any hemodynamically significant TTE features, aside from those (2/25) who had concomitant carcinoid heart disease. Of the 14 patients who had available TTE for review, only one with high metastatic cardiac tumor burden had detectable cardiac mass. Of the 6 cases who had available MRI, all had metastatic cardiac lesions seen with excellent correlation with tumor localization on 68Ga-DOTATATE PET scan. 68Ga-DOTATATE PET has excellent capability for the diagnosis of cardiac NET metastasis. Cardiac MRI may provide further anatomic and tissue characterization evaluation. Those with myocardial NET metastases without carcinoid heart disease did not have significant hemodynamic effect based on echocardiographic criteria.
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