Diffusion-weighted MR Imaging in Thymic Epithelial Tumors: Correlation with World Health Organization Classification and Clinical Staging

Razek, Ahmed Abdel Khalek Abdel; Khairy, Mohamed; Nada, Nadia

doi:10.1148/radiol.14131643

Cited by 91 publications

(73 citation statements)

References 37 publications

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“…Moreover, mean ADC of B3 thymoma was significantly lower than that of B2 thymoma. ADC levels were significantly associated with disease-free survival of patients with a recurrence rate being higher for patients with ADC ≤ 1.299 × 10 −3 mm 2 / s. To conclude, ADC helps to differentiate high-risk from low-risk thymomas and may be used as a prognostic indicator of recurrence, yet further studies are needed to validate these results [26,27]. conducted prospective/retrospective studies to quantitatively assess and differentiate benign and malignant mediastinal lesions using DWI.…”

Section: Discussionmentioning

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: Discussionmentioning

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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“…Such sequences, known to be penalized by motion and/or respiratory artefacts in uncooperative or dyspneic patients [16,17], could benefit from VP-MR.…”

Section: Discussionmentioning

confidence: 99%

Chest-MRI under pulsatile flow ventilation: A new promising technique

et al. 2017

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ObjectivesMagnetic resonance imaging (MRI) of the chest has long suffered from its sensitivity to respiratory and cardiac motion with an intrinsically low signal to noise ratio and a limited spatial resolution. The purpose of this study was to perform chest MRI under an adapted non invasive pulsatile flow ventilation system (high frequency percussive ventilation, HFPV®) allowing breath hold durations 10 to 15 times longer than other existing systems.MethodsOne volunteer and one patient known for a thymic lesion underwent a chest MRI under ventilation percussion technique (VP-MR). Routinely used sequences were performed with and without the device during three sets of apnoea on inspiration.ResultsVP-MR was well tolerated in both cases. The mean duration of the thoracic stabilization was 10.5 min (range 8.5–12) and 5.8 min (range 5–6.2) for Volunteer 1 and Patient 1, respectively. An overall increased image quality was seen under VP-MR with a better delineation of the mediastinal lesion for Patient 1. Nodules discovered in Volunteer 1 were confirmed with low dose CT.ConclusionVP-MR was feasible and increased spatial resolution of chest MRI by allowing acquisition at full inspiration during thoracic stabilization approaching prolonged apnoea. This new technique could be of benefit to numerous thoracic disorders.

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“…Radiomics can extract a high-throughput objective and quantitative image features from CT, magnetic resonance imaging (MRI), or positron emission tomography (PET) to reflect tumor heterogeneity [10][11][12] and explore the potential relationships between features and pathophysiology to predict clinical outcomes, such as differential diagnosis, classification, distant metastases, survival [13][14][15][16]. Image characteristic analysis, quantitative image analysis, and texture analysis have been used to differentiate high-risk thymomas from lowrisk thymomas according to the WHO classification, to differentiate advanced stage thymomas from early stage thymomas according to the Masaoka clinical stage with all types of thymic tumours and to distinguish anterior mediastinal cysts from other solid masses [17][18][19][20]; however, radiomics-based studies of only AMC distinguished from type B1 and B2 thymomas have not been reported. Therefore, this retrospective study attempts to study whether CT radiomics can reflect the heterogeneity between AMC and type B1 and B2 thymoma and to avoid the resection of AMC that are misdiagnosed as thymomas.…”

Section: Introductionmentioning

confidence: 99%

Can Computed Tomography-Based Radiomics Potentially Discrimination Between Anterior Mediastinal Cysts and type B1 and B2 thymomas

Liu

Pang

et al. 2020

Preprint

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Background Anterior mediastinal cysts (AMC) are often misdiagnosed as thymomas and undergo surgical resection, which caused unnecessary treatment and medical resources waste. The purpose of this study was to explore potential possibility of computed tomography (CT)-based radiomics for the diagnosis of AMC and type B1 and B2 thymomas. Methods A group of 188 patients with pathologically confirmed AMC (106 cases mischarged as thymomas in CT) and thymomas (82 cases) and underwent routine chest CT from January 2010 to December 2018 were retrospectively analyzed. The lesions were manually delineated using ITK-SNAP software, and radiomics features were performed using the Artificial Intelligence Kit (AK) software. A total of 396 tumor texture features were extracted from enhanced CT and unenhanced CT, respectively. The general test, correlation analysis and LASSO were used to features selection and then the radiomics signature (radscore) were obtained. The combined model including radscore and independent clinical factors were developed. The model performances were evaluated on discrimination, calibration curve. Results Two radscore model were constructed from the unenhanced and enhanced phases based on the selected 4 and 3 features, respectively. The AUC, sensitivity, and specificity of the enhanced radscore model were 0.928, 89.3% and 83.8% in the training dataset and 0.899, 84.6%, 87.5% in the test dataset (higher than the unenhanced radscore model). The combined model of enhanced CT including radiomics features and independent clinical factors yielded an AUC, sensitivity and specificity of 0.941, 82.1%, and 94.6% in the training dataset and 0.938, 92.3%, and 87.5% in the test dataset (higher than the unenhanced combined model and enhanced radscore model). Conclusions The study suggested the possibility that the combined model in enhanced CT provided a potential tool to facilitate the differential diagnosis of AMC and type B1 and B2 thymomas.

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Diffusion-weighted MR Imaging in Thymic Epithelial Tumors: Correlation with World Health Organization Classification and Clinical Staging

Abstract: ADC value is a noninvasive, reliable, and reproducible imaging parameter that may help to assess and characterize thymic epithelial tumors.

Cited by 91 publications

References 37 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

Chest-MRI under pulsatile flow ventilation: A new promising technique

Can Computed Tomography-Based Radiomics Potentially Discrimination Between Anterior Mediastinal Cysts and type B1 and B2 thymomas

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