Anterior mediastinal solid tumours in adults: characterisation using dynamic contrast-enhanced MRI, diffusion-weighted MRI, and FDG-PET/CT

Yabuuchi, Hidetake; Matsuo, Yoshio; Abe, Koichiro; Baba, Shingo; Sunami, Shunya; Kamitani, Takeshi; Yonezawa, Masato; Yamasaki, Yoshio; Kawanami, Satoshi; Nagao, Michinobu; Okamoto, Tatsuro; Nakamura, Katsumasa; Yamamoto, Hidetaka; Sasaki, Masayuki; Honda, Hiroshi

doi:10.1016/j.crad.2015.07.004

Cited by 52 publications

(77 citation statements)

References 23 publications

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“…Malignant anterior mediastinal lesions included in their study were thymic epithelial tumors (malignant thymoma and thymic carcinoma), lymphoma, and germ cell tumors. In agreement with our results, there was no significant difference between the ADC of these histopathological subtypes at both initial and validation studies [23].…”

Section: Discussionsupporting

confidence: 92%

Role of diffusion weighted MR-imaging in the evaluation of malignant mediastinal lesions

Sabri

Nossair

Assal

et al. 2020

Egypt J Radiol Nucl Med

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Background: Conducted studies showed that the ADC (apparent diffusion coefficient) values of malignant mediastinal lesions are significantly lower than those of benign lesions. Investigators determined cut-off ADC values to differentiate the two; concluding that ADC value is a promising noninvasive, imaging parameter that helps assess and characterize mediastinal tumors. Taking this a step forward, the primary objective of our prospective study was to investigate the potential of DW-MRI (diffusion-weighted magnetic resonance imaging) to characterize malignant mediastinal lesions using their ADC values. Thirty-three patients that underwent MRI of the chest with DWI and latter pathologically diagnosed with a malignant mediastinal lesion were included in this study. Lesions' ADC values were measured and correlated with the histopathological results. The statistical significance of differences between measurements was tested using the one-way ANOVA (analysis of variance) test; p values equal to or less than 0.05 were considered significant. Results: There was no statistically significant difference between the ADC mean values of the histopathological groups of lesions assessed with the overlap of their ADC mean values. The average ADC mean value of NHL (non-Hodgkin lymphoma) was evidently lower than that of HD (Hodgkin disease) with no overlap between their ADC mean values. DWI failed at characterizing one lesion in this study as a malignant tumor, namely an immature teratoma (germ-cell tumor). Again DWI could not be used to evaluate a mass, latter pathologically diagnosed as an angiosarcoma, because of its overall hemorrhagic nature showing no definite non-hemorrhagic soft tissue components. The aforementioned results did not differ considerably when minimum ADC was used instead of mean ADC. Conclusion: There was no statistically significant difference between the ADC values of the malignant mediastinal lesions evaluated. However, regarding lymphoma subtypes, our limited sample study of lymphoma suggested a considerable difference between the ADC values of Hodgkin disease and non-Hodgkin lymphoma.

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Section: Discussionsupporting

confidence: 92%

Role of diffusion weighted MR-imaging in the evaluation of malignant mediastinal lesions

Sabri

Nossair

Assal

et al. 2020

Egypt J Radiol Nucl Med

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“…In thoracic MRI examinations, DCE data are most often obtained using 3D T 1 ‐weighted spoiled fast GRE sequences, but older studies used 2D and spin echo sequences for this purpose . To improve the temporal resolution of a sequence used for DCE, the imaged volume can be limited to the specific tissue being evaluated.…”

Section: Building Blocksmentioning

confidence: 99%

“…While temporal resolution is variable, depending on the desired application and the sequences used, temporal resolution of ≤3 seconds is required to reliably obtain quantitative parameters for estimating neoangiogenesis . Motion correction software may be needed, particularly for high temporal resolution applications . Ultimately, DCE data can be used with DWI for a "multiparametric" approach, which allows for characterization of lesions before and after treatment …”

Section: Building Blocksmentioning

confidence: 99%

“…In thoracic MRI examinations, DCE data are most often obtained using 3D T 1 -weighted spoiled fast GRE sequences, but older studies used 2D and spin echo sequences for this purpose. 10,[58][59][60][61][62][63] To improve the temporal resolution of a sequence used for DCE, the imaged volume can be limited to the specific tissue being evaluated. Newer techniques allowing for faster imaging, including those using a radial acquisition of k-space and compressed sensing (eg, GRASP for Siemens), provide an improved means of obtaining images suitable for DCE in the thorax by increasing temporal resolution and decreasing the effects of motion.…”

Section: Functional Sequencesmentioning

confidence: 99%

“…27,64,65 Motion correction software may be needed, particularly for high temporal resolution applications. [58][59][60][61][62][63] Ultimately, DCE data can be used with DWI for a "multiparametric" approach, which allows for characterization of lesions before and after treatment. 27…”

Section: Functional Sequencesmentioning

confidence: 99%

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Building blocks for thoracic MRI: Challenges, sequences, and protocol design

Raptis

Ludwig

Hammer

et al. 2019

Magnetic Resonance Imaging

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Thoracic MRI presents important and unique challenges. Decreased proton density in the lung in combination with respiratory and cardiac motion can degrade image quality and render poorly executed sequences uninterpretable. Despite these challenges, thoracic MRI has an important clinical role, both as a problem‐solving tool and in an increasing array of clinical indications. Advances in scanner and sequence design have also helped to drive this development, presenting the radiologist with improved techniques for thoracic MRI. Given this evolving landscape, radiologists must be familiar with what thoracic MR has to offer. The first step in developing an effective thoracic MRI practice requires the creation of efficient and malleable protocols that can answer clinical questions. To do this, radiologists must have a working knowledge of the MR sequences that are used in the thorax, many of which have been adapted from use elsewhere in the body. These sequences can be broadly divided into three categories: traditional/anatomic, functional, and cine based. Traditional/anatomic sequences allow for the depiction of anatomy and pathologic processes with the ability for characterization of signal intensity and contrast enhancement. Functional sequences, including diffusion‐weighted imaging, and high temporal resolution dynamic contrast enhancement, allow for the noninvasive measurement of tissue‐specific parameters. Cine‐based sequences can depict the motion of structures in the thorax, either with retrospective ECG gating or in real time. The purpose of this article is to review these categories, the building block sequences that comprise them, and identify basic questions that should be considered in thoracic MRI protocol design. Level of Evidence: 5 Technical Efficacy Stage: 3 J. Magn. Reson. Imaging 2019;50:682–701.

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Contrast‐enhanced ultrasound features of mediastinal lymphomas and thymic epithelial tumors

Kong

Yang

et al. 2019

J of Clinical Ultrasound

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Objectives: To summarize the contrast-enhanced ultrasound (CEUS) features of mediastinal lymphomas and thymic epithelial tumors (including thymomas and thymic carcinomas) and to explore the value of CEUS in the differential diagnosis of lymphomas and thymic epithelial tumors. Methods: Sixty-nine patients with 69 mediastinal lesions who underwent CEUS and had disease confirmed by histopathology were enrolled in the study. There were 33 cases of lymphoma, 19 cases of thymic carcinoma, and 17 cases of thymoma. CEUS features, including the enhancement pattern, enhancement distribution, enhancement time, inner necrosis status, wash out pattern, and vascular morphology, were evaluated in each group. Results: Thymomas often presented with homogeneous (88.2%, 15/17) and late (88.2%, 15/17) enhancement and a low rate of inner necrosis (17.6%, 3/17). Late (73.7%, 14/19), heterogeneous (68.4%, 13/19), and centripetal (63.2%, 12/19) enhancement were more often observed in thymic carcinoma, as was a high rate of inner necrosis (78.9%, 15/19). Lymphomas showed a homogeneous enhancement rate of 57.6% (19/33) and a late enhancement rate of 54.5% (18/33). The rate of inner necrosis for lymphomas was 45.5% (15/33). The diagnostic accuracy of thisfinding for distinguishing thymic epithelial tumors from lymphomas was 63.8%, the sensitivity was 80.6%, and the specificity was 45.5%. Enlarged blood vessels were a feature specific to lymphomas, while small vessels arranged in a comb shape was a feature specific to thymic epithelial tumors.Conclusion: This study describes the CEUS features of common mediastinal tumors and may stimulate further studies in this field.

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Anterior mediastinal solid tumours in adults: characterisation using dynamic contrast-enhanced MRI, diffusion-weighted MRI, and FDG-PET/CT

Cited by 52 publications

References 23 publications

Role of diffusion weighted MR-imaging in the evaluation of malignant mediastinal lesions

Role of diffusion weighted MR-imaging in the evaluation of malignant mediastinal lesions

Building blocks for thoracic MRI: Challenges, sequences, and protocol design

Contrast‐enhanced ultrasound features of mediastinal lymphomas and thymic epithelial tumors

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