Conflicting or complementary role of computed tomography (<scp>CT</scp>) and positron emission tomography (<scp>PET</scp>)/<scp>CT</scp> in the assessment of thymic cancer and thymoma: our experience and literature review

Scagliori, Elena; Evangelista, Laura; Panunzio, Annalori; Calabrese, Fiorella; Nannini, Nazarena; Polverosi, Roberta; Pomerri, Fabio

doi:10.1111/1759-7714.12197

Cited by 16 publications

(18 citation statements)

References 21 publications

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“…Given the limitations of pathological examinations (e.g. a biopsy of the mass), imaging inspections, particularly CT examinations, are the most important basis for preoperative diagnosis . However, thymic cysts and thymoma are often incorrectly identified, causing patients to undergo unnecessary surgical treatment .…”

Section: Discussionmentioning

confidence: 99%

“…a biopsy of the mass), imaging inspections, particularly CT examinations, are the most important basis for preoperative diagnosis. 12 However, thymic cysts and thymoma are often incorrectly identified, causing patients to undergo unnecessary surgical treatment. 13 The major reason for misdiagnosis is that thymic cysts have a greater density than cysts of general significance, that is, a measurement > 20 Hu, which is a solid density in the conventional definition, resulting in a false diagnosis of thymoma before surgery.…”

Section: Discussionmentioning

confidence: 99%

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Multislice computed tomography performance in differential diagnosis of high‐density thymic cyst and thymoma in lesions less than 3 cm

Zhang

Wang

et al. 2018

Thoracic Cancer

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BackgroundThis study was conducted to evaluate the performance of multislice computed tomography (MSCT) to diagnose high‐density thymic cysts and thymomas in lesions measuring < 3 cm.MethodsThe records of 42 patients admitted to Ningbo No. 2 Hospital with an anterior mediastinal mass (diameter < 3 cm) suspected of carcinoma originating from the thymus were retrospectively analyzed. All patients underwent surgery and pathological examination. Twenty‐eight were diagnosed with thymic cysts and 14 with thymoma. The features of thymic cysts and thymomas revealed on MSCT were compared.ResultsMediastinal masses with a triangular or teardrop shape and a straight mediastina–lung border were more likely to be diagnosed as thymic cysts (P < 0.05), while those with a bulging nodule–lung border were more likely thymomas (P < 0.05). Using the CT value as a reference for differential diagnosis, the diagnostic sensitivity, specificity, and area under the receiver operating characteristic curve for CT values of non‐contrast CT images, enhanced CT values, and ΔCT values were 0.65 (0.47–0.84), 0.95(0.86–1.00), and 0.96 (0.89–1.00), respectively.ConclusionMSCT of high‐density thymus gland nodules (maximum diameter ≤ 3 cm) can reveal specific features that could be helpful for differential diagnosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Multislice computed tomography performance in differential diagnosis of high‐density thymic cyst and thymoma in lesions less than 3 cm

Zhang

Wang

et al. 2018

Thoracic Cancer

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“…Several studies evaluated the relationship between TLG and the Masaoka staging system for thymic epithelial tumors. [20][21][22] However, to our knowledge, there were no studies mentioning a cut-off value.…”

Section: Discussionmentioning

confidence: 95%

“…Newly suggested volumetric parameters, such as the metabolic tumor volume (MTV) and total lesion glycolytic activity (TLG), have recently been reported as additional diagnostic and prognostic biomarkers in various malignant tumors [16][17][18][19] ; however, few studies have examined the relationship between PET volumetric parameters and thymic epithelial tumors. [20][21][22][23] The purpose of the present study was to investigate the relationships between preoperative PET parameters, including SUVmax and other volumetric parameters, and the WHO classification or Masaoka staging system in patients with resected thymic epithelial tumors.…”

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confidence: 99%

Usefulness of Preoperative <sup>18</sup>F-FDG PET/CT for Patients with Thymic Epithelial Tumors

et al. 2019

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Background The purpose of this study was to investigate the relationship between preoperative FDG-PET parameters and the World Health Organization (WHO) classification or Masaoka staging system of thymic epithelial tumors. Methods We retrospectively reviewed 32 patients with histologically proven thymic epithelial tumors who underwent FDG-PET/CT before surgical resection. FDG-PET parameters, including the maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolytic activity (TLG), were measured. These PET parameters were compared in the Masaoka staging system and WHO classification. A receiver operating characteristics (ROC) analysis was performed to identify the cutoff values of PET parameters for the accurate differentiation of early and advanced stages in the Masaoka staging system. Results There were 17 low-risk thymomas (1 type A, 9 type AB, and 7 type B1), 8 high-risk thymomas (4 type B2 and 4 type B3), and 7 thymic carcinomas (7 squamous cell carcinoma). Their Masaoka stages were as follows: 24 in the early stage (stages I and II) and 8 in the advanced stage (stage III). Regarding the WHO classification, only SUVmax showed a significant difference (P < 0.05). In the Masaoka stage, all PET parameters were significantly higher in the advanced stage than in the early stage (P < 0.05). In the ROC analysis to predict the early and advanced stages in thymic epithelial tumors, the area under the curve was the highest for TLG among the PET parameters examined and the cutoff value of TLG for discriminating the early from advanced stage with maximal sensitivity and specificity was 30.735. Conclusion Although volumetric PET parameters, such as MTV and TLG, did not correlate with the WHO classification, a significant correlation was observed between SUVmax and the WHO classification. In the Masaoka staging system, volumetric PET parameters may achieve more precise staging than SUVmax.

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“…Therefore, the development of a non-invasive, simple and economical examination method would have clinical significance. Positron emission tomography (PET)/CT has previously been reported to exhibit certain value for grading the malignancies of thymic tumors (12,13), but this method would face difficulties spreading in developing countries due to economic factors. Images of thymoma have also previously been reported to be discovered in 99m Tc-methoxyisobutylisonitrile (MIBI) myocardial perfusion imaging by accident (14,15), which provided certain guidance for the present study.…”

Section: Introductionmentioning

confidence: 99%

Application values of 99mTc-methoxyisobutylisonitrile imaging for differentiating benign and malignant thymic masses

Wang

Liu

et al. 2017

Oncology Letters

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Abstract. The aim of the present study was to investigate the application value of 99m Tc-methoxyisobutylisonitrile (MIBI) imaging to differentiate between benign and malignant thymic masses. A total of 32 patients with space-occupying mediastinal masses were enrolled and early and delayed-phase images were collected following injection with the imaging agent. The tumor to background ratio (T/N) values at the different phases were also recorded. The sensitivity of the qualitative analysis to distinguish between benign and malignant thymic masses was 95.24%, with specificity as 90.91%. The T/N values in the early and delayed phases were not significantly different in the group with benign thymic masses, but demonstrated statistical significant differences in the groups with low-and intermediate-grade malignant thymic masses. The T/N values at the above early and delayed phase were significantly different between the benign and low-grade malignancy groups, as well as between low-and moderate-grade malignancy groups. Those between the benign and moderate-grade malignancy groups demonstrated no significant difference. 99m Tc-MIBI imaging was able to differentiate between benign and malignant thymic masses, and the simultaneous semi-quantitative analysis of the T/N values of the tumors may be able to initially determine the degree of malignancy of thymoma.

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Conflicting or complementary role of computed tomography (CT) and positron emission tomography (PET)/CT in the assessment of thymic cancer and thymoma: our experience and literature review

Cited by 16 publications

References 21 publications

Multislice computed tomography performance in differential diagnosis of high‐density thymic cyst and thymoma in lesions less than 3 cm

Multislice computed tomography performance in differential diagnosis of high‐density thymic cyst and thymoma in lesions less than 3 cm

Usefulness of Preoperative <sup>18</sup>F-FDG PET/CT for Patients with Thymic Epithelial Tumors

Application values of 99mTc-methoxyisobutylisonitrile imaging for differentiating benign and malignant thymic masses

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