Correlation of Computed Tomography Parameters with Histology, Stage and Prognosis in Surgically Treated Thymomas

Abstract

Background and objectives: The histological classification and staging of thymic tumors remains a matter of debate. The correlation of computed tomography (CT) parameters with tumor histology and stage also still has to be completely assessed. The aim of this study was therefore to analyze the correlation of radiological parameters with histological and staging classifications of thymomas evaluating their prognostic role. Materials and Methods: Data of 50 patients with thymoma submitted to a complete surgical treatment between 2005 and 2015 were retrospectively analyzed. Tumors were classified according to the WHO and Suster and Moran (S&M) histological classifications and to the Masaoka–Koga and tumor, node and metastases (TNM) staging systems. The correlation of CT features with histology and stage and the prognostic role of histopathological and radiological features were assessed. Results: Five-year overall (OS) and disease-free survival (DFS) were 90.3% and 81.1%, respectively. A significant correlation of DFS with the Masaoka–Koga (p = 0.001) and TNM staging systems (p = 0.002) and with the S&M (p = 0.02) and WHO histological classifications (p = 0.04) was observed. CT scan features correlated with tumor stage, histology and prognosis. Moderately differentiated tumors (WHO B3) had a significantly higher incidence of irregular shape and contours (p = 0.002 and p = 0.001, respectively) and pericardial contact (p = 0.036). A larger tumor volume (p = 0.03) and a greater length of pleural contact (p = 0.04) adversely influenced DFS. The presence of pleural (p < 0.001) or lung invasion (p = 0.02) and of pleural effusion (p = 0.004) was associated with a significantly worse OS. Conclusions: Pre-operative CT scan parameters correlate with stage and histology, and have a prognostic role in surgically treated thymomas.

Predicting the Risk of Thymic Tumors Using Texture Analysis of Contrast-Enhanced Chest Computed Tomography

“…Computed tomography (CT)–guided biopsy or thoracoscopic biopsy can clarify the pathological nature of tumors but cannot fully reflect the heterogeneity of the tumors or provide information, on invasion of surrounding structures or lymph node metastasis 5 . Chest CT is the most commonly used imaging modality for diagnosis mediastinal lesions.…”

“…4 Computed tomography (CT)-guided biopsy or thoracoscopic biopsy can clarify the pathological nature of tumors but cannot fully reflect the heterogeneity of the tumors or provide information, on invasion of surrounding structures or lymph node metastasis. 5 Chest CT is the most commonly used imaging modality for diagnosis mediastinal lesions. Although contrast-enhanced computed tomography (CECT) can help assess risk of malignancy for large thymic epithelial tumors, it is not reliable for small tumors with regular well-defined margins.…”