Evaluation of Anterior Mediastinal Solid Tumors by CT Perfusion: a Preliminary Study

Overview

Journal Diagn Interv Radiol

Publisher Galenos Publishing House

Date 2016 Dec 8

PMID 27924778

Citations 12

Authors

Selim Bakan

Sedat Giray Kandemirli

Atilla Suleyman Dikici

Ezel Ersen

Onur Yildirim

Cesur Samanci

Sebnem Batur

Deniz Cebi Olgun

Fatih Kantarci

Canan Akman

Affiliations

Soon will be listed here.

Abstract

Purpose: We aimed to assess the role of computed tomography (CT) perfusion in differentiation of thymoma from thymic hyperplasia, lymphoma, thymic carcinoma, and lung cancer invading anterior mediastinum.

Methods: In this study, 25 patients with an anterior mediastinal lesion underwent CT perfusion imaging from January 2015 to February 2016. Diagnoses included thymoma (n=7), thymic hyperplasia (n=8), lymphoma (n=4), thymic carcinoma (n=3), and invasive lung cancer (n=3). Lymphoma, thymic carcinoma, and lung cancer were grouped as malignant tumors for statistical analysis. Values for blood flow, blood volume, and permeability surface were measured in CT perfusion.

Results: Blood flow and blood volume values were higher in thymoma in comparison to thymic hyperplasia; however, the difference was not statistically significant. Blood volume values were significantly higher in thymoma (mean, 11.4 mL/100 mL; range, 5.2-20.2 mL/100 mL) compared with lymphoma (mean, 5.3 mL/100 mL; range, 2.5-7.2 mL/100 mL) (P = 0.023). Blood flow and blood volume values were significantly higher in thymoma compared with non-thymoma malignant tumors (P = 0.025).

Conclusion: CT perfusion is helpful in differentiating thymoma from non-thymoma malignancies including lymphoma, thymic carcinoma, and invasive lung cancer involving the anterior mediastinum.

Citing Articles

CT radiomics and human-machine hybrid system for differentiating mediastinal lymphomas from thymic epithelial tumors.

Xia H, Yu J, Nie K, Yang J, Zhu L, Zhang S Cancer Imaging. 2024; 24(1):163.

PMID: 39609913 PMC: 11603948. DOI: 10.1186/s40644-024-00808-2.

Undifferentiated pleomorphic sarcoma in the anterior mediastinum: a case report and literature review.

Wang L, Xie A, Ke L, Jia P, Li Y, Guo X Front Oncol. 2024; 14:1445149.

PMID: 39474109 PMC: 11518729. DOI: 10.3389/fonc.2024.1445149.

Avoiding misdiagnosis of multilocular thymic cysts as malignant tumors on computer tomography.

Zhang Y, Liu Y, Shen K, Wu J, Tang F World J Clin Cases. 2024; 12(19):3671-3675.

PMID: 38994317 PMC: 11235420. DOI: 10.12998/wjcc.v12.i19.3671.

Imaging evaluation of thymic tumors.

Strange C, Truong M, Ahuja J, Strange T, Patel S, Marom E Mediastinum. 2023; 7:28.

PMID: 37701637 PMC: 10493619. DOI: 10.21037/med-22-58.

Usefulness of Three-Dimensional Iodine Mapping Quantified by Dual-Energy CT for Differentiating Thymic Epithelial Tumors.

Doi S, Yanagawa M, Matsui T, Hata A, Kikuchi N, Yoshida Y J Clin Med. 2023; 12(17).

PMID: 37685677 PMC: 10488564. DOI: 10.3390/jcm12175610.

References

Nasseri F, Eftekhari F . Clinical and radiologic review of the normal and abnormal thymus: pearls and pitfalls. Radiographics. 2010; 30(2):413-28. DOI: 10.1148/rg.302095131. View

Ackman J, Verzosa S, Kovach A, Louissaint Jr A, Lanuti M, Wright C . High rate of unnecessary thymectomy and its cause. Can computed tomography distinguish thymoma, lymphoma, thymic hyperplasia, and thymic cysts?. Eur J Radiol. 2015; 84(3):524-533. DOI: 10.1016/j.ejrad.2014.11.042. View

Higuchi T, Taki J, Kinuya S, Yamada M, Kawasuji M, Matsui O . Thymic lesions in patients with myasthenia gravis: characterization with thallium 201 scintigraphy. Radiology. 2001; 221(1):201-6. DOI: 10.1148/radiol.2211001047. View

Sakai S, Murayama S, Soeda H, Matsuo Y, Ono M, Masuda K . Differential diagnosis between thymoma and non-thymoma by dynamic MR imaging. Acta Radiol. 2002; 43(3):262-8. DOI: 10.1080/j.1600-0455.2002.430306.x. View

Ferdinand B, Gupta P, Kramer E . Spectrum of thymic uptake at 18F-FDG PET. Radiographics. 2004; 24(6):1611-6. DOI: 10.1148/rg.246045701. View

Yabuuchi H, Matsuo Y, Abe K, Baba S, Sunami S, Kamitani T . Anterior mediastinal solid tumours in adults: characterisation using dynamic contrast-enhanced MRI, diffusion-weighted MRI, and FDG-PET/CT. Clin Radiol. 2015; 70(11):1289-98. DOI: 10.1016/j.crad.2015.07.004. View

Kent M, Wang T, Gangadharan S, Whyte R . What is the prevalence of a "nontherapeutic" thymectomy?. Ann Thorac Surg. 2013; 97(1):276-82. DOI: 10.1016/j.athoracsur.2013.07.121. View

Goldstein A, Oliva I, Honarpisheh H, Rubinowitz A . A tour of the thymus: a review of thymic lesions with radiologic and pathologic correlation. Can Assoc Radiol J. 2014; 66(1):5-15. DOI: 10.1016/j.carj.2013.09.003. View

Takahashi K, Inaoka T, Murakami N, Hirota H, Iwata K, Nagasawa K . Characterization of the normal and hyperplastic thymus on chemical-shift MR imaging. AJR Am J Roentgenol. 2003; 180(5):1265-9. DOI: 10.2214/ajr.180.5.1801265. View

10.

Shin K, Yi C, Kim T, Lee H, Choi Y, Kim H . Diffusion-weighted MRI for distinguishing non-neoplastic cysts from solid masses in the mediastinum: problem-solving in mediastinal masses of indeterminate internal characteristics on CT. Eur Radiol. 2013; 24(3):677-84. DOI: 10.1007/s00330-013-3054-0. View

11.

Marom E . Advances in thymoma imaging. J Thorac Imaging. 2013; 28(2):69-80. DOI: 10.1097/RTI.0b013e31828609a0. View

12.

Ackman J, Mino-Kenudson M, Morse C . Nonsuppressing normal thymus on chemical shift magnetic resonance imaging in a young woman. J Thorac Imaging. 2012; 27(6):W196-8. DOI: 10.1097/RTI.0b013e318249936a. View

13.

Sadohara J, Fujimoto K, Muller N, Kato S, Takamori S, Ohkuma K . Thymic epithelial tumors: comparison of CT and MR imaging findings of low-risk thymomas, high-risk thymomas, and thymic carcinomas. Eur J Radiol. 2006; 60(1):70-9. DOI: 10.1016/j.ejrad.2006.05.003. View

14.

Seki S, Koyama H, Ohno Y, Nishio M, Takenaka D, Maniwa Y . Diffusion-weighted MR imaging vs. multi-detector row CT: Direct comparison of capability for assessment of management needs for anterior mediastinal solitary tumors. Eur J Radiol. 2014; 83(5):835-42. DOI: 10.1016/j.ejrad.2014.01.005. View

15.

Tomiyama N, Honda O, Tsubamoto M, Inoue A, Sumikawa H, Kuriyama K . Anterior mediastinal tumors: diagnostic accuracy of CT and MRI. Eur J Radiol. 2007; 69(2):280-8. DOI: 10.1016/j.ejrad.2007.10.002. View

16.

Nishino M, Ashiku S, Kocher O, Thurer R, Boiselle P, Hatabu H . The thymus: a comprehensive review. Radiographics. 2006; 26(2):335-48. DOI: 10.1148/rg.262045213. View

17.

Trojanowska A, Trojanowski P, Bisdas S, Staskiewicz G, Drop A, Klatka J . Squamous cell cancer of hypopharynx and larynx - evaluation of metastatic nodal disease based on computed tomography perfusion studies. Eur J Radiol. 2011; 81(5):1034-9. DOI: 10.1016/j.ejrad.2011.01.084. View