Malignant versus benign mediastinal lesions: quantitative assessment with diffusion weighted MR imaging

Gümüştaş, Sevtap; İnan, Nagihan; Sarisoy, Hasan Tahsin; Anık, Yonca; Arslan, Arzu; Çıftçı, Ercüment; Akansel, Gür; Demırcı, Ali

doi:10.1007/s00330-011-2180-9

Cited by 66 publications

(63 citation statements)

References 21 publications

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“…8 reported for non-invasive THY in previous studies. 10,11 This discordance could be related to the "perfusion bias" with a consequent overestimation in ADC measurements of those studies. Indeed, as both the investigators used also the images obtained with b values of 0 s/mm 2 for the ADC computation, the ADC value was determined not only by diffusion (related to cell density and cellular architecture) but also by tissue perfusion.…”

Section: Discussionmentioning

confidence: 94%

“…For children and adolescents, this finding is consistent with a previous study that evaluated the fatty replacement of the normal thymus with chemical-shift MRI in 95 healthy volunteers. 20 Those investigators found that chemical-shift MRI can detect physiological fatty infiltration of the normal thymus in all subjects ≥16 years, in half of adolescents aged [10][11][12][13][14][15][16] years, but in none <10 years, although a microscopic and gradually increasing amount of fat in the normal thymus exists from birth. 20 In addition, a recent report described a case of non-suppressing normal thymus in a 21-year-old woman.…”

Section: Discussionmentioning

confidence: 99%

“…The correct prediction of early or advanced disease before surgery at imaging is essential to plan treatment strategies, because the latter receives neo-adjuvant chemotherapy [2]. Unfortunately, there is no perfect correlation among Jeong and Masaoka-Koga classifications because, although low-risk thymomas are frequently grouped in the earlydisease group, percentages of high-risk thymomas are reported at a rate up to 45 % in the early stage disease group [10]. Limited data are available on quantitative assessment of thymic epithelial tumours (TETs) by using diffusionweighted magnetic resonance imaging (DW-MRI) from small cohorts of studies which considered various anterior mediastinal tumours, although those studies did not attempt to differentiate thymomas based on WHO and MasaokaKoga classifications by using the ADC [11][12][13][14][15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

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Diffusion-weighted magnetic resonance imaging of thymoma: ability of the Apparent Diffusion Coefficient in predicting the World Health Organization (WHO) classification and the Masaoka-Koga staging system and its prognostic significance on disease-free survival

Priola

Giraudo³

et al. 2015

Eur Radiol

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Objectives: To evaluate the usefulness of diffusion-weighted magnetic resonance for distinguishing thymomas according to WHO and Masaoka-Koga classifications and in predicting disease-free survival (DFS) by using the apparent diffusion coefficient (ADC). Methods:Forty-one patients were grouped based on WHO (low-risk vs. high-risk) and MasaokaKoga (early vs. advanced) classifications. For prognosis, seven patients with recurrence at followup were grouped separately from healthy subjects. Differences on ADC levels between groups were tested using Student-t testing. Logistic regression models and areas under the ROC curve (AUROC) were estimated. Results:Mean ADC values were different between groups of WHO (low-risk=1.58±0.20×10-3mm2/sec; high-risk=1.21±0.23×10-3mm2/sec; p<0.0001) and Masaoka-Koga (early=1.43±0.26×10-3mm2/sec; advanced=1.31±0.31×10-3mm2/sec; p=0.016) classifications.Mean ADC of type-B3 (1.05±0.17×10-3mm2/sec) was lower than type-B2 (1.32±0.20×10-3mm2/sec; p=0.023). AUROC in discriminating groups was 0.864 for WHO classification (cutpoint=1.309×10-3mm2/sec; accuracy=78.1 %) and 0.730 for Masaoka-Koga classification (cut-point=1.243×10-3mm2/sec; accuracy=73.2 %). Logistic regression models and two-way ANOVA were significant for WHOclassification (odds ratio[OR]=0.93, p=0.007; p<0.001), but not for Masaoka-Koga classification (OR=0.98, p=0.31; p=0.38). ADC levels were significantly associated with DFS recurrence rate being higher for patients with ADC≤1.299× 10-3mm2/sec (p=0.001; AUROC, 0.834; accuracy=78.0 %).Conclusions: ADC helps to differentiate high-risk from lowrisk thymomas and discriminates the more aggressive type-B3. Primary tumour ADC is a prognostic indicator of recurrence. Key Points• DW-MRI is useful in characterizing thymomas and in predicting disease-free survival.• ADC can differentiate low-risk from high-risk thymomas based on different histological composition • The cutoff-ADC-value of 1.309×10-3mm2/sec is proposed as optimal cut-point for this differentiation • The ADC ability in predicting Masaoka-Koga stage is uncertain and needs further validations• ADC has prognostic value on disease-free survival and helps in stratification of risk

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Diffusion-weighted magnetic resonance imaging of thymoma: ability of the Apparent Diffusion Coefficient in predicting the World Health Organization (WHO) classification and the Masaoka-Koga staging system and its prognostic significance on disease-free survival

Priola

Giraudo³

et al. 2015

Eur Radiol

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“…T 2 weighted MRI was superior to pre-contrastenhanced CT in the depiction of the internal heterogeneity of the tumour. Razek et al 15 and Gumustas et al 16 reported that the mean apparent diffusion coefficient (ADC) of malignant mediastinal masses was significantly lower than that of benign mediastinal masses. They also mentioned that cystic or necrotic parts interfered with ADC value.…”

Section: Discussionmentioning

confidence: 99%

CT and MRI findings of thymic carcinoid

Shimamoto

Ashizawa

Kido

et al. 2017

The British Journal of Radiology

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Objective: To evaluate the CT and MRI findings of thymic carcinoid and to compare these findings with previously published findings of thymoma. Methods: 11 cases of pathologically proven thymic carcinoid were reviewed retrospectively. Three patients had typical carcinoid, and eight patients had atypical carcinoid. The characteristics of the tumours and related thoracic abnormalities were assessed in each case on CT and/or MRI by two chest radiologists. The final decisions on the findings were reached by consensus. Results: Thymic carcinoids were more likely to have a large mass (ranging from 18 to 105 mm), irregular contours (n 5 8), heterogeneous intensity on T 2 weighted images (n 5 6; eight patients underwent MRI), heterogeneous enhancement (n 5 9) and local invasion (n 5 7).A necrotic or cystic component was identified in seven patients (one typical carcinoid and six atypical carcinoids). Lymphadenopathy was seen in four patients. Septum, capsule, haemorrhage and calcification were seen in three patients, two patients, two patients and one patient, respectively, with atypical carcinoid. Conclusion: Thymic carcinoids tend to have a high prevalence of large masses, irregular contours, heterogeneous intensity on T 2 weighted images, heterogeneous enhancement and local invasion on CT and/or MRI. A necrotic or cystic component is often seen in atypical carcinoid. Advances in knowledge: Radiologic features of thymic carcinoid mimic those of high-risk thymomas and/or thymic carcinomas.

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“…Conclusion Diffusion-weighted MR imaging is a promising non-invasive imaging modality that can be used for differentiation of malignant from benign mediastinal lymphadenopathy in children. [17,18]. Diffusion-weighted MR imaging has also been used for characterization of mediastinal [19,20], abdominal [21], neck [22], and axillary [23] lymph nodes.…”

Section: Introductionmentioning

confidence: 99%

Diffusion-weighted MR imaging of mediastinal lymphadenopathy in children

et al. 2015

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Malignant versus benign mediastinal lesions: quantitative assessment with diffusion weighted MR imaging

Abstract: Diffusion-weighted imaging may be helpful in differentiating benign from malignant mediastinal masses.

Cited by 66 publications

References 21 publications

Diffusion-weighted magnetic resonance imaging of thymoma: ability of the Apparent Diffusion Coefficient in predicting the World Health Organization (WHO) classification and the Masaoka-Koga staging system and its prognostic significance on disease-free survival

Diffusion-weighted magnetic resonance imaging of thymoma: ability of the Apparent Diffusion Coefficient in predicting the World Health Organization (WHO) classification and the Masaoka-Koga staging system and its prognostic significance on disease-free survival

CT and MRI findings of thymic carcinoid

Diffusion-weighted MR imaging of mediastinal lymphadenopathy in children

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