Thymic Hyperplasia and Thymus Gland Tumors: Differentiation with Chemical Shift MR Imaging<sup>1</sup>

Inaoka, Tsukasa; Takahashi, Koji; Mineta, Masayuki; Yamada, Terumasa; Shuke, Noriyuki; Okizaki, Atsutaka; Nagasawa, Keiichi; Sugimori, Hiroyuki; Aburano, Tamio

doi:10.1148/radiol.2433060797

Cited by 192 publications

(141 citation statements)

References 26 publications

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“…In a series of 41 patients consisting of 23 thymic hyperplasia and 18 thymic neoplasm, chemical shift MRI could differentiate thymic hyperplasia from thymic neoplasms in all patients. All patients with hyperplastic thymus showed an apparent decrease in the signal intensity of the thymus at opposed-phase images in contrast to inphase images while none of the patients with thymic tumors showed a decrease in signal intensity at opposed-phase images (16) (Fig. 2).…”

Section: Thymic Hyperplasia and Thymic Reboundmentioning

confidence: 95%

“…A recent report suggested chemical shift MRI to be beneficial in differentiation of thymomas from thymic hyperplasia in non-MG patients (15,16). MRI may provide similar results also in MG patients.…”

Section: Thymomamentioning

confidence: 99%

“…Dynamic multiphase gadolinium-enhanced study is useful in the assessment of vascularity and extracellular space volume of the lesions. Chemical shift imaging with 2D GRE is useful to detect tiny amounts of fat tissue in the mixture with water within the lesions (15,16) (Figs. 1, 2).…”

Section: Imaging Technique Mrmentioning

confidence: 99%

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Computed tomography and magnetic resonance imaging of mediastinal tumors

Takahashi¹,

Al-Janabi²

2010

Magnetic Resonance Imaging

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We describe the clinical, pathological, and imaging findings of mediastinal tumors with focus on thymic hyperplasia, thymic epithelial tumors, and germ cell tumors, malignant lymphoma, and various cystic masses. Chemical shift magnetic resonance imaging (MRI) is useful in characterization of the normal thymus and differentiation of hyperplastic thymus and thymic tumors. In contrast to noninvasive thymomas, invasive thymomas and thymic carcinomas show a more aggressive growth pattern. Local invasion and pleural spread are characteristic of invasive thymoma and mediastinal lymphadenopathy and distant metastasis suggest thymic carcinomas. Mature teratoma typically shows various computed tomography (CT) attenuation, and MR signal intensity depending on its contents and fat tissue and bone within the lesions are its characteristic findings. Seminomas typically have homogenous internal CT attenuation and MR signal intensity with minimal contrast enhancement. Nonseminomatous malignant germ cell tumors characteristically show prominent internal degenerative changes and invasion to the adjacent structures. In mediastinal lymphomas, a residual mass is common after treatment and MRI provides important information in distinguishing viable tumors from residual benign masses. Some mediastinal cysts may reveal high attenuation similar to solid lesions on CT depending on their contents and MRI can be useful in the differentiation of cystic masses from solid lesions.

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Section: Thymic Hyperplasia and Thymic Reboundmentioning

confidence: 95%

Section: Thymomamentioning

confidence: 99%

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Computed tomography and magnetic resonance imaging of mediastinal tumors

Takahashi¹,

Al-Janabi²

2010

Magnetic Resonance Imaging

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165

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“…Thymomas are benign or low-grade malignant tumours of the thymic epithelium and represent up to half of all neoplasms of the anterior mediastinum [1][2][3][4][5][6]. The histological classification proposed by the World Health Organization (WHO) and the Masaoka-Koga staging system, based on surgical findings, is currently used for treatment planning and significantly correlate with prognosis [1][2][3][4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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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“…Thymic epithelial tumors usually can be assessed with computed tomography (CT) and magnetic resonance imaging (MRI) [1,2]. Morphologic features are used for characterizing thymic lesions, such as the contours and shapes of the lesions, the presence of necrosis, calcification, mediastinal fat or great vessel invasion, contrast enhancement, and adjacent lymph node enlargement.…”

mentioning

confidence: 99%

Usefulness of Fluorine-18 Fluorodeoxyglucose-Positron Emission Tomography in Management Strategy for Thymic Epithelial Tumors

Matsumoto

Oda

Takizawa

et al. 2013

The Annals of Thoracic Surgery

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Thymic Hyperplasia and Thymus Gland Tumors: Differentiation with Chemical Shift MR Imaging¹

Cited by 192 publications

References 26 publications

Computed tomography and magnetic resonance imaging of mediastinal tumors

Computed tomography and magnetic resonance imaging of mediastinal tumors

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

Usefulness of Fluorine-18 Fluorodeoxyglucose-Positron Emission Tomography in Management Strategy for Thymic Epithelial Tumors

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Thymic Hyperplasia and Thymus Gland Tumors: Differentiation with Chemical Shift MR Imaging1

Cited by 192 publications

References 26 publications

Computed tomography and magnetic resonance imaging of mediastinal tumors

Computed tomography and magnetic resonance imaging of mediastinal tumors

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

Usefulness of Fluorine-18 Fluorodeoxyglucose-Positron Emission Tomography in Management Strategy for Thymic Epithelial Tumors

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Thymic Hyperplasia and Thymus Gland Tumors: Differentiation with Chemical Shift MR Imaging¹