Diagnostic accuracy of cardiovascular magnetic resonance imaging in cardiac tumors: a systematic review with meta-analysis

Abstract

Purpose: Cardiac tumours (CT) diagnosis's gold standard is histopathological examination. Cardiovascular magnetic resonance (CMR) is a valuable non-invasive radiation-free tool for identifying and characterising CT. Our aim is to understand how accurate CMR is when compared to the gold standard. Methods: A systematic search was performed in PubMed, Web of Science and Scopus databases up until December 2022 and the results were reviewed by two independent investigators. Studies reporting CMR accuracy were included in a meta-analysis and pooled measures were obtained. The risk of bias was assessed using the Quality Assessment Tools from the National Institutes of Health. Results: A total of 2321 results were obtained; ten studies were eligible, including one identified by citation search. Eight studies were included in the meta-analysis, which presented a pooled sensitivity of 93% and specificity of 94%, a diagnostic odds ratio of 185 and an AUC of 0.98 for CMR diagnosing benign vs malignant tumours. Additionally, 4 studies evaluated whether CMR diagnosis of CT matched specific histopathological subtypes, with 73.6% of correct diagnoses. Conclusion: To the best of our knowledge, this is the first published systematic review reporting on the accuracy of CMR in diagnosing CT. CMR showed high accuracy in the differentiation of benign and malignant tumours; though the capacity of distinguishing subtypes was not outstanding. However, substantial heterogeneity may affect our findings.