{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T08:27:04Z","timestamp":1765268824380,"version":"build-2065373602"},"reference-count":25,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T00:00:00Z","timestamp":1652054400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>With the increasing availability of high-performance medical imaging for the management of patients with neuroendocrine tumors (NETs), a progressive growth of asymptomatic and incidentally detected cardiac metastases (CMs) has been observed in the recent years. In clinical practice, CMs of NENs are often incidentally detected by whole-body 68Ga-labeled somatostatin analogs or 18F-fluorodihydroxyphenylalanine positron emission tomography\/computed tomography, and afterwards accurately characterized by cardiac magnetic resonance (CMR) and\/or gated cardiac computed tomography when CMR is contraindicated or not available. The interpreting physician should familiarize with the main imaging features of CM, a finding that may be encountered in NETs patients more than previously thought. Herein, we present a case series of four patients with CMs from small-intestine NETs highlighting strengths and weaknesses of a multimodality imaging approach in clinical practice.<\/jats:p>","DOI":"10.3390\/diagnostics12051182","type":"journal-article","created":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T21:23:27Z","timestamp":1652131407000},"page":"1182","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Cutting-Edge Imaging of Cardiac Metastases from Neuroendocrine Tumors: Lesson from a Case Series"],"prefix":"10.3390","volume":"12","author":[{"given":"Soraya","family":"El Ghannudi","sequence":"first","affiliation":[{"name":"Nuclear Medicine, Institut de Canc\u00e9rologie de Strasbourg Europe (ICANS), University Hospitals of Strasbourg, 67093 Strasbourg, France"},{"name":"Department of Radiology, University Hospitals of Strasbourg, 67098 Strasbourg, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Ouvrard","sequence":"additional","affiliation":[{"name":"Nuclear Medicine, Institut de Canc\u00e9rologie de Strasbourg Europe (ICANS), University Hospitals of Strasbourg, 67093 Strasbourg, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nidaa","family":"Mikail","sequence":"additional","affiliation":[{"name":"Nuclear Medicine, ENETS Centre of Excellence, Beaujon Hospital (APHP), 92110 Clichy, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Leroy Freschini","sequence":"additional","affiliation":[{"name":"Nuclear Medicine, Institut de Canc\u00e9rologie de Strasbourg Europe (ICANS), University Hospitals of Strasbourg, 67093 Strasbourg, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas H.","family":"Schindler","sequence":"additional","affiliation":[{"name":"Division of Nuclear Medicine, Mallinckrodt Institute of Radiology, Washington University, St. Louis, MO 63110, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessio","family":"Imperiale","sequence":"additional","affiliation":[{"name":"Nuclear Medicine, Institut de Canc\u00e9rologie de Strasbourg Europe (ICANS), University Hospitals of Strasbourg, 67093 Strasbourg, France"},{"name":"Molecular Imaging\u2014DRHIM, IPHC, UMR 7178, CNRS\/Unistra, 67093 Strasbourg, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1001\/jamaoncol.2017.0589","article-title":"Trends in the incidence, prevalence, and survival outcomes in patients with neuroendocrine tumors in the United States","volume":"3","author":"Dasari","year":"2017","journal-title":"JAMA Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1159\/000443167","article-title":"ENETS Consensus Guidelines Update for theManagement of Distant Metastatic Disease of Intestinal, Pancreatic, Bronchial Neuroendocrine Neoplasms (NEN) and NEN of Unknown Primary Site","volume":"103","author":"Pavel","year":"2016","journal-title":"Neuroendocrinology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1007\/s12020-014-0272-4","article-title":"Myocardial metastases from neuroendocrine tumors: Incidence and relevance","volume":"47","author":"Kwekkeboom","year":"2014","journal-title":"Endocrine"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.ijcard.2014.02.037","article-title":"The clinical presentation and management of carcinoid heart disease","volume":"173","author":"Dobson","year":"2014","journal-title":"Int. J. Cardiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1159\/000287277","article-title":"ENETS Consensus Guidelines for the Management of Brain, Cardiac and Ovarian Metastases from Neuroendocrine Tumors","volume":"91","author":"Pavel","year":"2010","journal-title":"Neuroendocrinology"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1328","DOI":"10.1016\/S0735-1097(02)02109-5","article-title":"Metastatic carcinoid tumor to the heart: Echocardiographic-pathologic study of 11 patients","volume":"40","author":"Pandya","year":"2002","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1007\/s11864-019-0662-1","article-title":"Cardiac Tumors: Clinical Presentation, Diagnosis, and Management","volume":"20","author":"Poterucha","year":"2019","journal-title":"Curr. Treat. Options Oncol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1340","DOI":"10.2967\/jnumed.119.227231","article-title":"Summary of the First ISMRM\u2013SNMMI Workshop on PET\/MRI: Applications and Limitations","volume":"60","author":"Hope","year":"2019","journal-title":"J. Nucl. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1949","DOI":"10.2967\/jnumed.116.179234","article-title":"Molecular imaging of gastroenteropancreatic neuroendocrine tumors: Current status and future directions","volume":"57","author":"Deroose","year":"2016","journal-title":"J. Nucl. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1111\/cen.14312","article-title":"Intraindividual comparison of 18F-FDOPA and 68Ga-DOTATOC PET\/CT detection rate for metastatic assessment in patients with ileal neuroendocrine tumours","volume":"94","author":"Ouvrard","year":"2021","journal-title":"Clin. Endocrinol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Noordzij, W., van Beek, A.P., Tio, R.A., van der Horst-Schrivers, A.N., de Vries, E.G., van Ginkel, B., Walenkamp, A.M., Glaudemans, A.W., Slart, R.H., and Dierckx, R.A. (2014). Myocardial metastases on 6-[18F] fluoro-L-DOPA PET\/CT: A retrospective analysis of 116 serotonin producing neuroendocrine tumour patients. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0112278"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1159\/000510444","article-title":"Cardiac Metastases in Patients with Neuroendocrine Tumours: Clinical Features, Therapy Outcomes, and Prognostic Implications","volume":"111","author":"Liu","year":"2020","journal-title":"Neuroendocrinology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1097\/MNM.0000000000001064","article-title":"The heart matters: A review of incidental cardiac uptake on Ga-68 DOTA peptide PET-CT scans","volume":"40","author":"Moyade","year":"2019","journal-title":"Nucl. Med. Commun."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1007\/s10554-017-1065-7","article-title":"Incremental value of cardiac magnetic resonance for the evaluation of cardiac tumors in adults: Experience of a high volume tertiary cardiology centre","volume":"33","author":"Giusca","year":"2017","journal-title":"Int. J. Cardiovasc. Imaging"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1270","DOI":"10.1016\/j.jcmg.2019.09.002","article-title":"PET\/CMR: One More Step Toward Noninvasive Morphofunctional Diagnosis of Cardiac Malignancies","volume":"13","author":"Germain","year":"2020","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1016\/j.ijcard.2015.09.021","article-title":"Cardiac MRI-based multi-modality imaging in clinical decision-making: Preliminary assessment of a management algorithm for patients with suspected cardiac mass","volume":"203","author":"Zhu","year":"2016","journal-title":"Int. J. Cardiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e003368","DOI":"10.1161\/JAHA.116.003368","article-title":"Pattern and Prognostic Implications of Cardiac Metastases Among Patients With Advanced Systemic Cancer Assessed With Cardiac Magnetic Resonance Imaging","volume":"5","author":"Pun","year":"2016","journal-title":"J. Am. Heart Assoc."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/S0169-5002(02)00172-1","article-title":"Tumor necrosis is an independent prognostic marker in non-small cell lung cancer: Correlation with biological variables","volume":"37","author":"Winson","year":"2002","journal-title":"Lung Cancer"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"9281","DOI":"10.1007\/s12410-014-9281-1","article-title":"Cardiac Masses on Cardiac CT: A Review","volume":"7","author":"Kassop","year":"2014","journal-title":"Curr. Cardiovasc. Imaging Rep."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1007\/s11886-019-1196-7","article-title":"The Assessment of Cardiac Masses by Cardiac CT and CMR Including Pre-op 3D Reconstruction and Planning","volume":"21","author":"Liddy","year":"2019","journal-title":"Curr. Cardiol. Rep."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2216","DOI":"10.1161\/CIRCULATIONAHA.107.186093","article-title":"The role of endomyocardial biopsy in the management of cardiovascular disease: A scientific statement from the American Heart Association, the American College of Cardiology, and the European Society of Cardiology","volume":"116","author":"Cooper","year":"2007","journal-title":"Circulation"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1053\/j.semnuclmed.2021.03.001","article-title":"Variants and Pitfalls of PET\/CT in Neuroendocrine Tumors","volume":"51","author":"Imperiale","year":"2021","journal-title":"Semin. Nucl. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1177\/0284185113496679","article-title":"Diagnostic role of gallium-68 DOTATOC and gallium-68 DOTATATE PET in patients with neuroendocrine tumors: A meta-analysis","volume":"55","author":"Yang","year":"2014","journal-title":"Acta Radiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1002\/bjs.6937","article-title":"Value of combined 6-[18F]fluorodihydroxyphenylalanine PET\/CT for imaging of neuroendocrine tumours","volume":"97","author":"Schiesser","year":"2010","journal-title":"J. Br. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1111\/cen.14527","article-title":"Head-to-head comparison between 18F-DOPA PET\/CT and 68Ga-DOTA peptides PET\/CT in detecting intestinal neuroendocrine tumours: A systematic review and meta-analysis","volume":"95","author":"Piccardo","year":"2021","journal-title":"Clin. 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