Maximizing information from routine staging computed tomography in functional neuroendocrine neoplasms: are there findings indicating the presence of carcinoid heart disease?

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Item Type:	Article
Title:	Maximizing information from routine staging computed tomography in functional neuroendocrine neoplasms: are there findings indicating the presence of carcinoid heart disease?
Creators Name:	Baur, A.D.J., Kunz, F., Schwenke, C., Pschowski, R., Roepke, T.K., Pavel, M. and Denecke, T.
Abstract:	PURPOSE: The aim of this study was to evaluate signs of right-sided heart dysfunction on staging computed tomography (CT) as indirect indicators of carcinoid heart disease. PATIENTS AND METHODS: Patients with functionally active neuroendocrine neoplasm and different grades of tricuspid valve regurgitation (TR) were identified. Two readers independently reviewed contrast-enhanced staging CT performed within 90 days before or after echocardiography. Logistic regression and receiver operating analyses were used to asses the predictive value of right ventricle-left ventricle ratio (RV-LV ratio), ventricular septal bowing, retrograde contrast filling of the hepatic veins during contrast injection, and time to aortal enhancement greater than 100 Hounsfield units during bolus tracking for TR. RESULTS: Forty-four examinations were evaluated (11 with TR = 0, 16 with TR = 1, 9 with TR = 2, and 8 with TR = 3). Right ventricle-LV ratio was found to predict TR less than or equal to 1 versus TR greater than 1 (P = 0.0188) and TR less than or equal to 1 versus TR equals 2 (P = 0.0082). A prolonged time to aortal enhancement greater than 100 Hounsfield units during bolus tracking predicted TR less than or equal to 1 versus TR greater than 1 (P = 0.0077). Area under the curve for RV-LV ratio was 0.86 when differentiating TR less than or equal to 1 versus TR equals 2. With a cutoff of 1.07, sensitivity was 0.89, and specificity was 0.72. CONCLUSIONS: In patients with functionally active neuroendocrine neoplasm, an RV-LV ratio of more than 1.07 predicted TR with a relatively high sensitivity and moderate specificity and thus could serve as an indicator of subclinical carcinoid heart disease on routine staging CT.
Keywords:	Computed Tomography, Staging, Neuroendocrine Tumor, Carcinoid Syndrome, Carcinoid Heart Disease
Source:	Journal of Computer Assisted Tomography
ISSN:	0363-8715
Publisher:	Lippincott Williams & Wilkins
Volume:	40
Number:	2
Page Range:	277-282
Date:	March 2016
Official Publication:	https://doi.org/10.1097/RCT.0000000000000354
PubMed:	View item in PubMed

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