Given the complexity of the human heart, let’s dig into its anatomy. The heart is a crucial organ with four key openings, and in its right atrium contains a structure called the Crista terminal. This function forms the cleavage ridge of the atrium, which divides it into a section with a complex network (the right atrial appendage of the path) and a smooth section (the sinus vein). Although crucial, its size and appearance can vary greatly, causing potential confusion in medical imaging. Interestingly, about 40% of people have obvious Crista terminals, with a higher incidence in women. This often overlooked anatomical detail can lead to serious misunderstandings, especially in complex imaging techniques.
The study, highlighted by Dr. Busra Cangut and her team, Dr. Lewen Stempler and Aiden Ghesani of the School of Medicine of Icahn Medical College in New York, stressed the need to correctly identify normal and non-damaging absorption in the mind. These findings, published in the peer-reviewed journal Radiology Case Report, reveal the important role of the risk of misdiagnosis and precise interpretation in medical imaging.
Details of Dr. Busra Cangut, “PET/CT scans for 18F-FDG (a radioglucose) used to determine the cancer stage showed strong activity in the right atrium, similar to prominent soft tissue. Subsequently, transesophageal echocardiac movements were used The deeper examination of the figure (TEE) finally confirmed that what was seen was actually a prominent Crista end, a common change in the anatomy of the heart. “The study focused on a 79-year-old woman with a new diagnosis of Breast cancer. Her 18F-FDG PET/CT scan, part of her cancer assessment, unexpectedly revealed significant activity in her right atrial activity, initially indicating a potentially dangerous mass. This observation on observation leads to further in-depth evaluation, which elucidates a prominent Crista end, a typical change in the heart structure.
“The Crista end is located in the right heart tract, extending along the side wall between the two main veins and the inferior vena cava. In some cases, the normal activity of F-18 FDG at the CRISTA end can be erroneously Identified as a tumor thrombosis. Therefore, it is crucial to gain insight into the normal uptake of standard heart structures and their changes when analyzing these images. ” Dr. Cangut stressed. This study is important to show the challenge of accurately interpreting these images. The Crista end can show signs that may be mistaken for tumor thrombosis, which is a concern for cancer patients. This study highlights the importance of thoroughly understanding normal physiological uptake and benign changes in standard heart structures to prevent misinterpretations.
These findings are particularly important for medical professionals. They stressed the need to carefully examine and interpret imaging results, taking into account benign changes. This awareness can alleviate unreasonable concerns between patients and doctors, prevent unnecessary other imaging procedures, and ensure timely and appropriate care. All in all, this study can remind you of the complexity and subtlety of medical imaging. It highlights the need for detailed review when interpreting scans to accurately distinguish between harmful and harmless discoveries. This particular situation illustrates the statement: “Not everything shines is gold”, emphasizing the need to consider normal heart changes when making a diagnosis.
Journal Reference
Aiden Ghesani, Busra Cangut, Lewen Stempler, “Not everything glows is gold, normal absorption in Crista Terminalis on FDG PET: CT masquerade as a tumor thrombus approaching right heart”, Radiation Case Report, 2024, 2024 Year. .org/10.1016/j.radcr.2023.10.068.
About the author
Dr. Busra CangutThe journey of medical education and research is rich and diverse. She received her medical degree from the School of Medicine of Istanbul-Mamara University. While attending medical school, she worked in prestigious institutions including Harvard, Cleveland Clinic and in the Department of Cardiac Surgery at the University of Texas. After graduating from medical school, she joined the Mayo Clinic Cardiac Surgery Division as a postdoctoral fellow, where she devoted a year of basic scientific research focusing on mouse models composed of advanced atherosclerotic plaques. Later, in her postdoctoral fellowship, she contributed to a clinical trial comparing different aortic valve bioplants.
Her academic pursuit continues to earn her master’s degree in clinical and translational sciences and has been a one-year intern at Mayo Clinic. Currently, Dr. Cangut is at Mount Sinai Hospital/New York, where she is deeply involved in cardiac imaging techniques tailored to specific valve pathology. Her work covers a variety of approaches to cardiothoracic surgery, integrating basic science, clinical expertise and imaging approaches to provide a comprehensive understanding of the field.
Dr. Cangut’s research interests focus on cutting-edge cardiac imaging techniques, especially the exploration of PET/MRI applications for specific valve pathology. In addition, she was awarded the ERAS Heart Scholarship Award, which is dedicated to optimizing perioperative care for patients with heart surgery. She is actively developing an order set designed to promote the extensive and seamless implementation of evidence-based perioperative care programs with the ultimate goal of improving patient outcomes. Driven by her passion for academic excellence, Dr. Kangut is eager to become an academic cardiac surgeon. Her field of vision involves the use of cardiac imaging for surgical planning and deepening understanding of disease pathology and its impact on the heart through advanced imaging techniques.
