Cardiac tumors: the role of magnetic resonance imaging

The incidental finding of a cardiac or paracardiac mass constitutes for cardiologists a relevant diagnostic and therapeutic problem. In fact, although primary cardiac tumors are infrequently, metastases, as well as non-neoplastic masses and pseudomasses, are much more frequent. A key role is played by echocardiography, but the latter is not always nullifying. Sometimes even the currently used imaging techniques may be limited in oncology. Cardiac magnetic resonance (CMR) is a multi-parametric technique of imaging considered nowadays the gold standard for non-invasive soft tissue characterization. CMR allows (i) to better evaluate the relationship between the tumor and adjacent structures, (ii) to detect the degree of infiltration or the expansion of the mass in the pericardium, and (iii) to predict the possible malignancy of a mass with a higher accuracy than other methods. In addition, CMR can favor the choice of the technique for surgical resection by providing information regarding cardiac function and the possible hemodynamic impairment. In this regard, we here present a narrative review on the most frequent cardiac manifestations of tumors, masses and pseudomasses, as well as the currently used CMR techniques in this setting.