1
|
Gadour E, Al Ghamdi S, Miutescu B, Shaaban HE, Hassan Z, Almuhaidb A, Okasha HH. Linear endoscopic ultrasound: Current uses and future perspectives in mediastinal examination. World J Gastroenterol 2024; 30:3803-3809. [DOI: 10.3748/wjg.v30.i33.3803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 08/18/2024] [Accepted: 08/20/2024] [Indexed: 09/02/2024] Open
Abstract
This editorial elaborates on the current and future applications of linear endoscopic ultrasound (EUS), a substantial diagnostic and therapeutic modality for various anatomical regions. The scope of endosonographic assessment is broad and, among other factors, allows for the evaluation of the mediastinal anatomy and related pathologies, such as mediastinal lymphadenopathy and the staging of central malignant lung lesions. Moreover, EUS assessment has proven more accurate in detecting small lesions missed by standard imaging examinations, such as computed tomography or magnetic resonance imaging. We focus on its current uses in the mediastinum, including lung and esophageal cancer staging, as well as evaluating mediastinal lymphadenopathy and submucosal lesions. The editorial also explores future perspectives of EUS in mediastinal examination, including ultrasound-guided therapies, artificial intelligence integration, advancements in mediastinal modalities, and improved diagnostic approaches for various mediastinal lesions.
Collapse
Affiliation(s)
- Eyad Gadour
- Department of Gastroenterology and Hepatology, King Abdulaziz National Guard Hospital, Ahsa 36428, Saudi Arabia
- Department of Internal Medicine, Zamzam University College, School of Medicine, Khartoum 11113, Sudan
| | - Sarah Al Ghamdi
- Department of Medicine, Division of Gastroenterology, King Abdulaziz University, Jeddah 3646, Saudi Arabia
| | - Bogdan Miutescu
- Department of Gastroenterology and Hepatology, Victor Babes University of Medicine and Pharmacy, Timisoara 300041, Romania
- Advanced Regional Research Center in Gastroenterology and Hepatology, Victor Babes University of Medicine and Pharmacy, Timisoara 300041, Romania
| | - Hossam E Shaaban
- Department of Internal Medicine and Gastroenterology, Nhtmri, Cairo 11796, Egypt
| | - Zeinab Hassan
- Department of Internal Medicine, Stockport Hospitals NHS Foundation Trust, Manchester SK2 7JE, United Kingdom
| | - Aymen Almuhaidb
- Department of Gastroenterology, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
| | - Hussein H Okasha
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kasr Al-Aini School of Medicine, Cairo University, Cairo 11562, Egypt
| |
Collapse
|
2
|
Taymour TA, Soliman ES, Al-Sayyad EH, Tadros SF. Can MRI chemical shift imaging replace thymic biopsy in myasthenia gravis patients? THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2022. [DOI: 10.1186/s43055-022-00717-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Abstract
Background
Myasthenia gravis is a neuromuscular junction autoimmune condition characterized by muscle weakness. Many people with myasthenia gravis have thymic abnormalities, such as thymic lymphoid hyperplasia and thymic tumors, therefore, the thymus plays a significant role in the disease. The imaging properties of thymic hyperplasia and thymoma on CT and conventional MRI are very similar, yet, MRI has recently revealed promising capability by adding novel sequences. Chemical shift MRI was demonstrated to consistently distinguish thymic hyperplasia from thymus gland tumors. The aim of this study was to determine the value of chemical shift MRI imaging in characterizing thymic lesions in patients diagnosed with myasthenia gravis and its ability to differentiate thymic hyperplasia from thymoma.
Results
MRI showed that thymic lymphoid hyperplasia was more common to be convex in shape while thymoma was more likely to be round or irregular (P = 0.004). Paired comparison between histopathology and chemical shift MRI showed that MRI had 90% sensitivity and 100% specificity in detecting thymoma with overall diagnostic accuracy 93.3% (P = 0.5). MRI chemical shift ratio showed 100% sensitivity by using > 0.85 as a cut off value for diagnosis of thymoma, with specificity 83.3% (P = 0.0001). There was statistically significant difference in chemical shift ratio between thymic lymphoid hyperplasia and thymoma groups, as thymoma group had a higher chemical shift ratio of 1.06 ± 0.06 compared to 0.48 ± 0.13 in thymic hyperplasia group (P = 0.0001).
Conclusion
MRI chemical shift imaging with chemical shift ratio offers a highly sensitive and specific tool in assessment of thymus lesions in myasthenia gravis patients and it can differentiate between thymic hyperplasia and thymoma using cutoff value of > 0.85, hence, unwarranted invasive procedures as thymic biopsy or thymectomy can be avoided and proper management could be planned.
Collapse
|
3
|
Lin CY, Yen YT, Huang LT, Chen TY, Liu YS, Tang SY, Huang WL, Chen YY, Lai CH, Fang YHD, Chang CC, Tseng YL. An MRI-Based Clinical-Perfusion Model Predicts Pathological Subtypes of Prevascular Mediastinal Tumors. Diagnostics (Basel) 2022; 12:diagnostics12040889. [PMID: 35453937 PMCID: PMC9026802 DOI: 10.3390/diagnostics12040889] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/18/2022] [Accepted: 03/31/2022] [Indexed: 12/10/2022] Open
Abstract
This study aimed to build machine learning prediction models for predicting pathological subtypes of prevascular mediastinal tumors (PMTs). The candidate predictors were clinical variables and dynamic contrast–enhanced MRI (DCE-MRI)–derived perfusion parameters. The clinical data and preoperative DCE–MRI images of 62 PMT patients, including 17 patients with lymphoma, 31 with thymoma, and 14 with thymic carcinoma, were retrospectively analyzed. Six perfusion parameters were calculated as candidate predictors. Univariate receiver-operating-characteristic curve analysis was performed to evaluate the performance of the prediction models. A predictive model was built based on multi-class classification, which detected lymphoma, thymoma, and thymic carcinoma with sensitivity of 52.9%, 74.2%, and 92.8%, respectively. In addition, two predictive models were built based on binary classification for distinguishing Hodgkin from non-Hodgkin lymphoma and for distinguishing invasive from noninvasive thymoma, with sensitivity of 75% and 71.4%, respectively. In addition to two perfusion parameters (efflux rate constant from tissue extravascular extracellular space into the blood plasma, and extravascular extracellular space volume per unit volume of tissue), age and tumor volume were also essential parameters for predicting PMT subtypes. In conclusion, our machine learning–based predictive model, constructed with clinical data and perfusion parameters, may represent a useful tool for differential diagnosis of PMT subtypes.
Collapse
Affiliation(s)
- Chia-Ying Lin
- Department of Medical Imaging, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan; (C.-Y.L.); (L.-T.H.); (Y.-S.L.)
| | - Yi-Ting Yen
- Division of Thoracic Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan; (Y.-T.Y.); (W.-L.H.); (Y.-Y.C.); (Y.-L.T.)
- Division of Trauma and Acute Care Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
| | - Li-Ting Huang
- Department of Medical Imaging, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan; (C.-Y.L.); (L.-T.H.); (Y.-S.L.)
| | - Tsai-Yun Chen
- Division of Hematology and Oncology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan;
| | - Yi-Sheng Liu
- Department of Medical Imaging, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan; (C.-Y.L.); (L.-T.H.); (Y.-S.L.)
| | - Shih-Yao Tang
- Department of Biomedical Engineering, National Cheng Kung University, Tainan 704, Taiwan;
| | - Wei-Li Huang
- Division of Thoracic Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan; (Y.-T.Y.); (W.-L.H.); (Y.-Y.C.); (Y.-L.T.)
| | - Ying-Yuan Chen
- Division of Thoracic Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan; (Y.-T.Y.); (W.-L.H.); (Y.-Y.C.); (Y.-L.T.)
| | - Chao-Han Lai
- Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan;
| | - Yu-Hua Dean Fang
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
- Correspondence: (Y.-H.D.F.); (C.-C.C.)
| | - Chao-Chun Chang
- Division of Thoracic Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan; (Y.-T.Y.); (W.-L.H.); (Y.-Y.C.); (Y.-L.T.)
- Correspondence: (Y.-H.D.F.); (C.-C.C.)
| | - Yau-Lin Tseng
- Division of Thoracic Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan; (Y.-T.Y.); (W.-L.H.); (Y.-Y.C.); (Y.-L.T.)
| |
Collapse
|
4
|
Rückert JC, Elsner A, Andreas MN. [Mediastinal Tumors]. Zentralbl Chir 2022; 147:99-120. [PMID: 35235970 DOI: 10.1055/a-1674-0693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
If mediastinal tumours cause symptoms these are related to their anatomical localization or a paraneoplastic syndrome. The differential diagnosis is based on the clinical situation with finding the lesion, and, furthermore, taking into account the age and sex of the patient, and the mediastinal compartment where the lesion is located. Cross-sectional radiographic diagnostic is essential for defining the therapeutic strategy. The anterior mediastinum is dominated by thymic tumours, mediastinal lymphomas, germ cell tumours and ectopic mediastinal poiters. The middle mediastinal compartment is the most frequent place of mediastinal cystic tumours, whereas the posterior mediastinum is the domain of neurogenic tumours. For selected cases a tissue biopsy is required. Surgery is the mainstay for most mediastinal tumours. Median sternotomy is the most frequent conventional surgical technique while minimally invasive surgery with thoracoscopic and above all robot assisted operation techniques are increasingly frequent. Combined chemotherapy and modern radiotherapy are essential components of the comprehensive treatment for mediastinal tumours.
Collapse
Affiliation(s)
- Jens-Carsten Rückert
- Chirurgische Klinik Campus Charité Mitte, Charité Universitätsmedizin, Berlin, Deutschland
| | | | | |
Collapse
|
5
|
Tuan PA, Duc NM. Magnetic resonance imaging characteristics of thymoma in Vietnamese patients with myasthenia gravis in relation to histopathological type and disease staging. Contemp Oncol (Pozn) 2020; 24:193-199. [PMID: 33235546 PMCID: PMC7670178 DOI: 10.5114/wo.2020.98861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 08/22/2020] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Myasthenia gravis (MG) is a relatively uncommon neuromuscular disease. The thymus plays an important role in the pathogenesis of MG, with 70% of patients presenting with thymic follicular hyperplasia and 20% presenting with thymoma. This study aimed to characterize magnetic resonance (MR) images of thymomas in patients with MG, associated with various stages and types. MATERIAL AND METHODS A prospective study was performed in 46 MG patients with thymoma, who underwent surgery between August 2014 and September 2018, in Vietnam. Differences in MR imaging (MRI) images, according to type and stage, were assessed by the χ2 test or Fisher's exact test and Student's t-test. A p-value < 0.05 was considered significant. RESULTS The proportions of each type of thymomas found to be invasive were 28.6%, 61.1%, 66.7%, 90.9%, and 100%, for type A, AB, B1, B2, and B3 thymomas, respectively. Heterogeneous signal intensities on T1- and T2-weighted images, necrosis, and cysts were more commonly observed in high-risk thymomas than in low-risk thymomas. Non-invasive thymomas were more likely to display smooth margins than invasive thymomas (p < 0.05). Only 16.7% of invasive thymomas were detected in MR findings. CONCLUSIONS Only a few characteristic MRI features could be used to differentiate thymomas by stage or type.
Collapse
Affiliation(s)
- Phung Anh Tuan
- Department of Radiology, Vietnam Military Medical University, Hanoi, Vietnam
| | - Nguyen Minh Duc
- Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
- Department of Radiology, Children’s Hospital 2, Ho Chi Minh City, Vietnam
| |
Collapse
|
6
|
Xiao G, Hu YC, Ren JL, Qin P, Han JC, Qu XY, Rong WC, Yan WQ, Tian Q, Han Y, Wang WP, Wang SM, Ma J, Wang W, Cui GB. MR imaging of thymomas: a combined radiomics nomogram to predict histologic subtypes. Eur Radiol 2020; 31:447-457. [PMID: 32700020 DOI: 10.1007/s00330-020-07074-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 05/15/2020] [Accepted: 07/13/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Accurately predicting the WHO classification of thymomas is urgently needed to optimize individualized therapeutic strategies. We aimed to develop and validate a combined radiomics nomogram for personalized prediction of histologic subtypes in patients with thymomas. METHODS A total of 182 thymoma patients were divided into training (n = 128) and test (n = 54) cohorts. Radiomics features were extracted from T2-weighted, T2-weighted fat suppression, and diffusion-weighted images to establish a radiomics signature in the training cohort. Multivariate logistic regression analysis was used to develop a combined radiomics nomogram that incorporated clinical, conventional MR imaging variables, apparent diffusion coefficient (ADC) value, and radiomics signature. The efficacy of clinical, conventional MR imaging, or ADC model was also evaluated respectively. The performances of different models were compared by receiver operating characteristic analysis and Delong test. The discrimination, calibration, and clinical usefulness of the combined radiomics nomogram were assessed. RESULTS The radiomics signature, consisting of 14 features, achieved favorable predictive efficacy in differentiating low-risk from high-risk thymomas, outperforming clinical, conventional MR imaging, and ADC models. The combined radiomics nomogram incorporating tumor shape, ADC value, and radiomics signature yielded the best performance (training cohort: area under the curve [AUC] = 0.946, test cohort: AUC = 0.878). The calibration curve and decision curve analysis indicated the clinical utility of the combined radiomics nomogram. CONCLUSIONS The radiomics signature is a useful tool that can be used to predict histologic subtypes of thymomas. The combined radiomics nomogram improved the individualized subtype prediction in patients with thymomas. KEY POINTS • Fourteen robust features were selected to develop a radiomics signature for preoperative prediction of thymoma subtype. • MRI-based radiomics signature can differentiate low-risk thymomas from high-risk thymomas with favorable predictive efficacy compared with clinical, conventional MR imaging, and ADC models. • Combined radiomics nomogram based on tumor shape, ADC value, and radiomics signature could improve the individualized subtype prediction in patients with thymomas.
Collapse
Affiliation(s)
- Gang Xiao
- Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi, People's Republic of China
- Functional and Molecular Imaging Key Lab of Shaanxi Province, Xi'an, Shaanxi, People's Republic of China
| | - Yu-Chuan Hu
- Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi, People's Republic of China
- Functional and Molecular Imaging Key Lab of Shaanxi Province, Xi'an, Shaanxi, People's Republic of China
| | | | - Peng Qin
- Student Brigade, Fourth Military Medical University, 169 Changle Road, Xi'an, 710032, Shaanxi, People's Republic of China
| | - Jia-Cheng Han
- Student Brigade, Fourth Military Medical University, 169 Changle Road, Xi'an, 710032, Shaanxi, People's Republic of China
| | - Xiao-Yan Qu
- Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi, People's Republic of China
| | - Wei-Cheng Rong
- Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi, People's Republic of China
- Functional and Molecular Imaging Key Lab of Shaanxi Province, Xi'an, Shaanxi, People's Republic of China
| | - Wei-Qiang Yan
- Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi, People's Republic of China
- Functional and Molecular Imaging Key Lab of Shaanxi Province, Xi'an, Shaanxi, People's Republic of China
| | - Qiang Tian
- Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi, People's Republic of China
- Functional and Molecular Imaging Key Lab of Shaanxi Province, Xi'an, Shaanxi, People's Republic of China
| | - Yu Han
- Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi, People's Republic of China
- Functional and Molecular Imaging Key Lab of Shaanxi Province, Xi'an, Shaanxi, People's Republic of China
| | - Wu-Ping Wang
- Department of Thoracic Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Shu-Mei Wang
- Department of Pathology, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Jiao Ma
- Department of Pathology, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Wen Wang
- Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi, People's Republic of China.
- Functional and Molecular Imaging Key Lab of Shaanxi Province, Xi'an, Shaanxi, People's Republic of China.
| | - Guang-Bin Cui
- Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi, People's Republic of China.
- Functional and Molecular Imaging Key Lab of Shaanxi Province, Xi'an, Shaanxi, People's Republic of China.
| |
Collapse
|
7
|
Role of diffusion weighted MR-imaging in the evaluation of malignant mediastinal lesions. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2020. [DOI: 10.1186/s43055-020-0132-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Abstract
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 ADCmean values of the histopathological groups of lesions assessed with the overlap of their ADCmean values. The average ADCmean value of NHL (non-Hodgkin lymphoma) was evidently lower than that of HD (Hodgkin disease) with no overlap between their ADCmean 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.
Collapse
|
8
|
Gentili F, Pelini V, Lucii G, Luzzi L, Mazzei FG, Fausto A, Volterrani L, Mazzei MA. Update in diagnostic imaging of the thymus and anterior mediastinal masses. Gland Surg 2019; 8:S188-S207. [PMID: 31559186 DOI: 10.21037/gs.2019.05.06] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Anterior mediastinal masses include a wide spectrum of malignant and benign pathologies with a large percentage represented by thymic lesions. Distinguishing these masses on diagnostic imaging is fundamental to guide the proper management for each patient. This review illustrates possibilities and limits of different imaging modalities to diagnose a lesion of the anterior mediastinum with particular attention to thymic disease.
Collapse
Affiliation(s)
- Francesco Gentili
- Department of Medicine, Surgery and Neuro Sciences, Diagnostic Imaging, University of Siena, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Veronica Pelini
- Department of Medicine, Surgery and Neuro Sciences, Diagnostic Imaging, University of Siena, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Gabriele Lucii
- Department of Medicine, Surgery and Neuro Sciences, Diagnostic Imaging, University of Siena, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Luca Luzzi
- Thoracic Surgery Unit, Department of Medicine, Surgery and Neuro Sciences, Diagnostic Imaging, University of Siena, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | | | - Alfonso Fausto
- Diagnostic Imaging, University of Siena, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Luca Volterrani
- Department of Medicine, Surgery and Neuro Sciences, Diagnostic Imaging, University of Siena, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Maria Antonietta Mazzei
- Department of Medicine, Surgery and Neuro Sciences, Diagnostic Imaging, University of Siena, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| |
Collapse
|
9
|
Tuan PA, Vien MV, Dong HV, Sibell D, Giang BV. The Value of CT and MRI for Determining Thymoma in Patients With Myasthenia Gravis. Cancer Control 2019; 26:1073274819865281. [PMID: 31331197 PMCID: PMC6651671 DOI: 10.1177/1073274819865281] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The aim of the study was to evaluate the usefulness of computed tomography (CT) and magnetic resonance imaging (MRI) for differentiating thymoma from nonthymoma abnormalities in patients with myasthenia gravis (MG). A cross-sectional study of 53 patients with MG, who had undergone surgical thymectomy, was conducted at 103 Hospital (Hanoi, Vietnam) and Cho Ray Hospital (Ho Chi Minh City, Vietnam) during August 2014 and January 2017. The CT and MRI images of patients with MG were qualitatively and quantitatively (radiodensity and chemical shift ratio [CSR]) analyzed to determine and compare their ability to distinguish thymoma from nonthymoma abnormalities. Logistic regression was used to identify the association between imaging parameters (eg, CSR) and the thymoma status. The receiver operating curve (ROC) analysis was used to determine the differentiating ability of CSR and radiodensity. As results, of the 53 patients with MG, 33 were with thymoma and 20 were with nonthymoma abnormalities. At qualitative assessment, MRI had significantly higher accuracy than did CT in differentiating thymoma from nonthymoma abnormalities (94.3% vs 83%). At quantitative assessment, both the radiodensity and CSR were significantly higher for thymoma compared with nonthymoma groups (P < .001). The ROC analysis showed that CSR had significantly higher sensitivity (Se) and specificity (Sp) than radiodensity in discriminating between the 2 groups (CSR: Se 100%, Sp 95% vs radiodensity: Se 90.9%, Sp 70%). When combining both qualitative and quantitative parameters, MRI had even higher accuracy than did CT in thymoma diagnosis (P = .031). In conclusion, chemical shift MRI was more accurate than CT for differentiating thymoma from nonthymoma in patients with MG.
Collapse
Affiliation(s)
| | | | | | - David Sibell
- 3 Oregon Health & Science University, Portland, OR, USA
| | | |
Collapse
|
10
|
Li HR, Gao J, Jin C, Jiang JH, Ding JY. Comparison between CT and MRI in the Diagnostic Accuracy of Thymic Masses. J Cancer 2019; 10:3208-3213. [PMID: 31289591 PMCID: PMC6603368 DOI: 10.7150/jca.30240] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 04/15/2019] [Indexed: 12/22/2022] Open
Abstract
Purpose: The aim of this study was to compare diagnostic accuracy between CT and MRI for thymic masses. Methods: We searched literature and collected information on first author, publication year, cases of different types of thymic lesions, correct diagnostic cases of CT and MRI and results of quantitative analysis of CT and MRI. The ROC curve was applied to compare the diagnostic performance of different imaging modalities. Results: Eight literatures were finally included and analyzed in this study. There were 253 cases examined by CT and 340 cases by MRI in total. We showed outcomes of quantitative analysis of each study in this article. The sensitivity of CT and MRI was both 100%, while the specificity was 75% and 80%, respectively. AUC of CT was 0.875 [95%CI: 0.473, 0.997] and that of MRI was 0.880 [95%CI: 0.531, 0.995]. Conclusion: The diagnostic accuracy of MRI is superior to CT in detecting thymomas, thymic cysts or thymic hyperplasia but that of CT and MRI is still unclear in differentiating thymic carcinomas and lymphomas/germ cell tumors.
Collapse
Affiliation(s)
- Hao-Ran Li
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, 200032, Shanghai, China
| | - Jian Gao
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, 200032, Shanghai, China
| | - Chun Jin
- Department of Thoracic Surgery, Xuhui District Center Hospital of Shanghai, 200031, Shanghai, China
| | - Jia-Hao Jiang
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, 200032, Shanghai, China
| | - Jian-Yong Ding
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, 200032, Shanghai, China
| |
Collapse
|
11
|
Predicting pathological subtypes and stages of thymic epithelial tumors using DWI: value of combining ADC and texture parameters. Eur Radiol 2019; 29:5330-5340. [DOI: 10.1007/s00330-019-06080-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 01/16/2019] [Accepted: 02/07/2019] [Indexed: 12/20/2022]
|
12
|
Priola AM, Priola SM. Morphological assessment of thymic carcinoma through imaging: is computed tomography useful in selecting patients for surgery and in predicting incomplete resection? J Thorac Dis 2019; 10:S3933-S3937. [PMID: 30631520 DOI: 10.21037/jtd.2018.09.97] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | - Sandro Massimo Priola
- Department of Diagnostic Imaging, San Luigi Gonzaga University Hospital, Orbassano, Torino 10043, Italy
| |
Collapse
|
13
|
Perfusion bias in the apparent diffusion coefficient measurements of diffusion-weighted magnetic resonance imaging. TUMORI JOURNAL 2018. [DOI: 10.5301/tj.5000650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
14
|
A Thymic Hyperplasia Case without Suppressing on Chemical Shift Magnetic Resonance Imaging. Case Rep Radiol 2018; 2018:7305619. [PMID: 29862111 PMCID: PMC5971343 DOI: 10.1155/2018/7305619] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 03/26/2018] [Accepted: 04/01/2018] [Indexed: 01/25/2023] Open
Abstract
A 22-year-old woman with myasthenia gravis (MG) presented with ptosis and mild muscle weakness symptoms for one year. Computed tomography (CT) presented a diffuse bilobulate enlargement gland with a high density of soft tissue. Magnetic resonance imaging (MRI) showed the gland with no suppression on the opposed-phase chemical shift. After the thymic tumor diagnosis, she underwent thoracoscopic surgery for tumor resection. The postoperative histopathological finding was thymic lymphoid hyperplasia. This case suggests chemical shift MRI is not enough in distinguishing, and supplementary examination is essential to avoid unnecessary thymic biopsy and surgery.
Collapse
|
15
|
Calandriello L, Larici AR, Sica G, Ciliberto M, Manfredi R. The added value of chemical shift MRI in the preoperative diagnosis of thymolipoma. TUMORI JOURNAL 2018; 104:NP57-NP60. [PMID: 29714656 DOI: 10.1177/0300891618763204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Thymolipoma is a rare tumor of the thymus. Classic radiologic findings of thymolipoma include fatty masses of the anterior mediastinum in conjunction with the thymus. Differential diagnosis with other more aggressive entities like liposarcoma and teratoma can be challenging. We report a case where chemical shift magnetic resonance imaging helped in the differential diagnosis.
Collapse
Affiliation(s)
- Lucio Calandriello
- Institute of Radiology, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - Anna Rita Larici
- Institute of Radiology, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - Giuliano Sica
- Institute of Radiology, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - Mario Ciliberto
- Institute of Radiology, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - Riccardo Manfredi
- Institute of Radiology, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| |
Collapse
|
16
|
Priola AM, Veltri A, Priola SM. Mediastinal and Pleural MR Imaging in Daily Practice. Radiographics 2018; 38:981-982. [DOI: 10.1148/rg.2018180011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Affiliation(s)
- Adriano M. Priola
- Department of Diagnostic Imaging, San Luigi Gonzaga Hospital, University of Torino, Regione Gonzole 10, 10043 Orbassano (Torino), Italy
| | - Andrea Veltri
- Department of Diagnostic Imaging, San Luigi Gonzaga Hospital, University of Torino, Regione Gonzole 10, 10043 Orbassano (Torino), Italy
| | - Sandro M. Priola
- Department of Diagnostic Imaging, San Luigi Gonzaga Hospital, University of Torino, Regione Gonzole 10, 10043 Orbassano (Torino), Italy
| |
Collapse
|
17
|
Hayes SA, Huang J, Golia Pernicka J, Cunningham J, Zheng J, Moskowitz CS, Ginsberg MS. Radiographic Predictors of Resectability in Thymic Carcinoma. Ann Thorac Surg 2018. [PMID: 29534953 DOI: 10.1016/j.athoracsur.2018.02.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND The aim of this study was to assess preoperative computed tomography characteristics of thymic carcinomas and to investigate which features could predict an incomplete surgical resection. A secondary aim was to correlate preoperative imaging features with Masaoka stage. METHODS In this study, approved by our Institutional Review Board, two readers retrospectively reviewed preoperative computed tomography scans at our tertiary referral oncology center between 1994 and 2014. Imaging features analyzed included tumor morphology, infiltration of surrounding mediastinal fat, loss of surrounding fat plane, degree of contact between tumor and great vessels, and associated pulmonary or pleural abnormality. Surgical and pathologic records were reviewed for completeness of surgical resection and Masaoka stage. RESULTS Forty-one patients were included, with Masaoka stage I (n = 3), stage II (n = 4), stage III (n = 12), and stage IV (n = 22). Twenty-one patients (51%) had a complete surgical resection. Ten had microscopic residual disease (R1) with involved surgical margins at pathology, and 10 patients had macroscopic residual disease (R2) at surgery. In addition to lesion size, the feature associated with incomplete surgical resection was the degree of tumor contact with adjacent mediastinal vessels on the preoperative computed tomography image (p = 0.038). Many of the more common features associated with incomplete resection were also more likely to be present in patients with late Masaoka stage (III/IV), including infiltration of the mediastinal fat, which was present in all 34 patients with Masaoka stage III/IV compared with 5 patients (71%) with stage I/II (p = 0.03). CONCLUSIONS Preoperative computed tomography imaging features may help to identify patients at risk for an incomplete surgical resection.
Collapse
Affiliation(s)
- Sara A Hayes
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.
| | - James Huang
- Department of Surgery, Thoracic Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | | | - Junting Zheng
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Chaya S Moskowitz
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Michelle S Ginsberg
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| |
Collapse
|
18
|
Priola AM, Priola SM, Gned D, Giraudo MT, Veltri A. Nonsuppressing normal thymus on chemical-shift MR imaging and anterior mediastinal lymphoma: differentiation with diffusion-weighted MR imaging by using the apparent diffusion coefficient. Eur Radiol 2017; 28:1427-1437. [PMID: 29143106 DOI: 10.1007/s00330-017-5142-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 09/14/2017] [Accepted: 10/18/2017] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To prospectively evaluate usefulness of the apparent diffusion coefficient (ADC) in differentiating anterior mediastinal lymphoma from nonsuppressing normal thymus on chemical-shift MR, and to look at the relationship between patient age and ADC. METHODS Seventy-three young subjects (25 men, 48 women; age range, 9-29 years), who underwent chemical-shift MR and diffusion-weighted MR were divided into a normal thymus group (group A, 40 subjects), and a lymphoma group (group B, 33 patients). For group A, all subjects had normal thymus with no suppression on opposed-phase chemical-shift MR. Two readers measured the signal intensity index (SII) and ADC. Differences in SII and ADC between groups were tested using t-test. ADC was correlated with age using Pearson correlation coefficient. RESULTS Mean SII±standard deviation was 2.7±1.8% for group A and 2.2±2.4% for group B, with no significant difference between groups (P=.270). Mean ADC was 2.48±0.38x10-3mm2/s for group A and 1.24±0.23x10-3mm2/s for group B. A significant difference between groups was found (P<.001), with no overlap in range. Lastly, significant correlation was found between age and ADC (r=0.935, P<.001) in group A. CONCLUSIONS ADC of diffusion-weighted MR is a noninvasive and accurate parameter for differentiating lymphoma from nonsuppressing thymus on chemical-shift MR in young subjects. KEY POINTS • SII cannot differentiate mediastinal lymphoma from nonsuppressing normal thymus at visual assessment • ADC is useful for distinguishing nonsuppressing normal thymus from mediastinal lymphoma • ADC is more accurate than transverse-diameter and surface-area in this discrimination • ADC of normal thymus is age dependent and increases with increasing age.
Collapse
Affiliation(s)
- Adriano Massimiliano Priola
- Department of Diagnostic Imaging, San Luigi Gonzaga University Hospital, Regione Gonzole 10, 10043, Orbassano, Torino, Italy.
| | - Sandro Massimo Priola
- Department of Diagnostic Imaging, San Luigi Gonzaga University Hospital, Regione Gonzole 10, 10043, Orbassano, Torino, Italy
| | - Dario Gned
- Department of Diagnostic Imaging, San Luigi Gonzaga University Hospital, Regione Gonzole 10, 10043, Orbassano, Torino, Italy
| | - Maria Teresa Giraudo
- Department of Mathematics, "Giuseppe Peano", University of Torino, Via Carlo Alberto 10, 10123, Torino, Italy
| | - Andrea Veltri
- Department of Diagnostic Imaging, San Luigi Gonzaga University Hospital, Regione Gonzole 10, 10043, Orbassano, Torino, Italy
| |
Collapse
|
19
|
Priola AM, Veltri A, Priola SM. CT perfusion in characterizing anterior mediastinal solid tumors. Diagn Interv Radiol 2017; 23:331. [PMID: 28703106 PMCID: PMC5508959 DOI: 10.5152/dir.2017.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 02/27/2017] [Indexed: 11/22/2022]
Affiliation(s)
- Adriano Massimiliano Priola
- From the Department of Diagnostic Imaging (A.M.P. ), San Luigi Gonzaga Hospital, University of Torino, Torino, Italy
| | - Andrea Veltri
- From the Department of Diagnostic Imaging (A.M.P. ), San Luigi Gonzaga Hospital, University of Torino, Torino, Italy
| | - Sandro Massimo Priola
- From the Department of Diagnostic Imaging (A.M.P. ), San Luigi Gonzaga Hospital, University of Torino, Torino, Italy
| |
Collapse
|
20
|
Water and lipid diffusion MRI using chemical shift displacement-based separation of lipid tissue (SPLIT). Magn Reson Imaging 2017; 39:144-148. [PMID: 28216452 DOI: 10.1016/j.mri.2017.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 02/14/2017] [Accepted: 02/15/2017] [Indexed: 02/03/2023]
Abstract
PURPOSE To obtain water and lipid diffusion-weighted images (DWIs) simultaneously, we devised a novel method utilizing chemical shift displacement-based separation of lipid tissue (SPLIT) imaging. MATERIALS AND METHODS Single-shot diffusion echo-planar imaging without fat suppression was used and the imaging parameters were optimized to separate water and lipid DWIs by chemical shift displacement of the lipid signals along the phase-encoding direction. Using the optimized conditions, transverse DWIs at the maximum diameter of the right calf were scanned with multiple b-values in five healthy subjects. Then, apparent diffusion coefficients (ADCs) were calculated in the tibialis anterior muscle (TA), tibialis bone marrow (TB), and subcutaneous fat (SF), as well as restricted and perfusion-related diffusion coefficients (D and D*, respectively) and the fraction of the perfusion-related diffusion component (F) for TA. RESULTS Water and lipid DWIs were separated adequately. The mean ADCs of the TA, TB, and SF were 1.56±0.03mm2/s, 0.01±0.01mm2/s, and 0.06±0.02mm2/s, respectively. The mean D*, D, and F of the TA were 13.7±4.3mm2/s, 1.48±0.05mm2/s, and 4.3±1.6%, respectively. CONCLUSION SPLIT imaging makes it possible to simply and simultaneously obtain water and lipid DWIs without special pulse sequence and increases the amount of diffusion information of water and lipid tissue.
Collapse
|
21
|
Priola AM, Priola SM, Gned D, Giraudo MT, Brundu M, Righi L, Veltri A. Diffusion-weighted quantitative MRI of pleural abnormalities: Intra- and interobserver variability in the apparent diffusion coefficient measurements. J Magn Reson Imaging 2017; 46:769-782. [PMID: 28117923 DOI: 10.1002/jmri.25633] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 12/28/2016] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To assess intra- and interobserver variability in the apparent diffusion coefficient (ADC) measurements of pleural abnormalities. MATERIALS AND METHODS Diffusion-weighted magnetic resonance imaging was performed in 34 patients to characterize pleural abnormalities, with a 1.5T unit at b values of 0/150/500/800 sec/mm2 . In two sessions held 3 months apart, on perfusion-free ADC maps, two independent readers measured the ADC of pleural abnormalities (two readings for each reader in each case) using different methods of region-of-interest (ROI) positioning. In three methods, freehand ROIs were drawn within tumor boundaries to encompass the entire lesion on one or more axial slices (whole tumor volume [WTV], three slices observer-defined [TSOD], single-slice [SS]), while in two methods one or more ROIs were placed on the more restricted areas (multiple small round ROI [MSR], one small round ROI [OSR]). Measurement variability between readings by each reader (intraobserver repeatability) and between readers in first reading (interobserver repeatability) were assessed using intraclass correlation coefficient (ICC) and coefficient of variation (CoV). Analysis of variance (ANOVA) was performed to compare ADC values between the different methods. The measurement time of each case for all methods in first reading was recorded and compared between methods and readers. RESULTS All methods demonstrated good (MSR, OSR) and excellent (WTV, TSOD, SS) intra- and interreader agreement, with best and worst repeatability in WTV (lower ICC, 0.977; higher CoV, 3.5%) and OSR (lower ICC, 0.625; higher CoV, 22.8%), respectively. The lower 95% confidence interval of ICC resulted in fair to moderate agreement for OSR (up to 0.379) and in excellent agreement for WTV, TSV, and SS (up to 0.918). ADC values of OSR and MSR were significantly lower compared to other methods (P < 0.001). The OSR and SS required less measurement time (10 and 21/22 sec, respectively) compared to the others (P < 0.0001), while the WTV required the longest measurement time (132/134 sec) (P < 0.0001). CONCLUSION ADC measurements of pleural abnormalities are repeatable. The SS method has excellent repeatability, similar to WTV, but requires significantly less measurement time. Thus, its use should be preferred in clinical practice. LEVEL OF EVIDENCE 4 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;46:769-782.
Collapse
Affiliation(s)
| | - Sandro Massimo Priola
- Department of Diagnostic Imaging, San Luigi Gonzaga University Hospital, Orbassano (Torino), Italy
| | - Dario Gned
- Department of Diagnostic Imaging, San Luigi Gonzaga University Hospital, Orbassano (Torino), Italy
| | | | - Maria Brundu
- Department of Diagnostic Imaging, San Luigi Gonzaga University Hospital, Orbassano (Torino), Italy
| | - Luisella Righi
- Department of Pathology, San Luigi Gonzaga University Hospital, Orbassano (Torino), Italy
| | - Andrea Veltri
- Department of Diagnostic Imaging, San Luigi Gonzaga University Hospital, Orbassano (Torino), Italy
| |
Collapse
|
22
|
Liu S, Zhen F, Sun N, Chen J, Cao Y, Zhang S, Cheng H, Ge X, Sun X. Apparent diffusion coefficient values detected by diffusion-weighted imaging in the prognosis of patients with locally advanced esophageal squamous cell carcinoma receiving chemoradiation. Onco Targets Ther 2016; 9:5791-5796. [PMID: 27703377 PMCID: PMC5036604 DOI: 10.2147/ott.s107466] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Purpose Previous studies have demonstrated that apparent diffusion coefficient (ADC) values measured by magnetic resonance imaging have prognostic value in patients with esophageal squamous cell carcinoma (ESCC). However, the role of ADC needs to be validated in a cohort of Chinese ESCC patients. This study assessed the role of ADC in predicting the outcome of patients with ESCC treated only by chemoradiation in the People’s Republic of China. Patients and methods Seventy-three patients with local advanced ESCC were retrospectively analyzed in this study; none of the patients underwent surgery before or after chemoradiation. The ADC values of the primary tumors were determined by magnetic resonance imaging. The ADC values were then correlated with clinicopathological and other radiological parameters. Survival analysis was carried out to determine if ADC had an impact on survival of these patients. Results The median ADC value of the esophageal cancer tissue was 1.256*10−3 mm2/sec (range: 0.657–2.354*10−3 mm2/sec, interquartile range 0.606*10−3 mm2/sec). No clinicopathological or radiological parameters were associated with the ADC values except the sites of tumor tissues. ADC <1.076*10−3 mm2/sec predicted significantly worse survival in patients with ESCC (12.9 months vs undefined, P=0.0108). Conclusion The ADC value is a potent prognostic factor which can be used to predict the outcome of patients with ESCC treated only by chemoradiation.
Collapse
Affiliation(s)
- Shu Liu
- Department of Radiation Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China
| | - Fuxi Zhen
- Department of Thoracic Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China
| | - Nana Sun
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China
| | - Jiayan Chen
- Department of Radiation Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China
| | - Yuandong Cao
- Department of Radiation Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China
| | - Sheng Zhang
- Department of Radiation Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China
| | - Hongyan Cheng
- Department of General Internal Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China
| | - Xiaolin Ge
- Department of Radiation Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China
| | - Xinchen Sun
- Department of Radiation Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China
| |
Collapse
|
23
|
Priola AM, Priola SM, Gned D, Piacibello E, Sardo D, Parvis G, Torti D, Ardissone F, Veltri A. Diffusion-weighted quantitative MRI to diagnose benign conditions from malignancies of the anterior mediastinum: Improvement of diagnostic accuracy by comparing perfusion-free to perfusion-sensitive measurements of the apparent diffusion coefficient. J Magn Reson Imaging 2016; 44:758-769. [DOI: 10.1002/jmri.25203] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Affiliation(s)
| | - Sandro Massimo Priola
- Department of Diagnostic Imaging; San Luigi Gonzaga University Hospital; Orbassano (Torino) Italy
| | - Dario Gned
- Department of Diagnostic Imaging; San Luigi Gonzaga University Hospital; Orbassano (Torino) Italy
| | - Edoardo Piacibello
- Department of Diagnostic Imaging; San Luigi Gonzaga University Hospital; Orbassano (Torino) Italy
| | - Diego Sardo
- Department of Diagnostic Imaging; San Luigi Gonzaga University Hospital; Orbassano (Torino) Italy
| | - Guido Parvis
- Department of Internal Medicine and Hematology; San Luigi Gonzaga University Hospital; Orbassano (Torino) Italy
| | - Davide Torti
- Department of Internal Medicine and Hematology; San Luigi Gonzaga University Hospital; Orbassano (Torino) Italy
| | - Francesco Ardissone
- Department of Thoracic Surgery; San Luigi Gonzaga University Hospital; Orbassano (Torino) Italy
| | - Andrea Veltri
- Department of Diagnostic Imaging; San Luigi Gonzaga University Hospital; Orbassano (Torino) Italy
| |
Collapse
|
24
|
Re. Clin Nucl Med 2016; 41:748. [DOI: 10.1097/rlu.0000000000001301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
25
|
Schob S, Meyer J, Gawlitza M, Frydrychowicz C, Müller W, Preuss M, Bure L, Quäschling U, Hoffmann KT, Surov A. Diffusion-Weighted MRI Reflects Proliferative Activity in Primary CNS Lymphoma. PLoS One 2016; 11:e0161386. [PMID: 27571268 PMCID: PMC5003362 DOI: 10.1371/journal.pone.0161386] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 08/04/2016] [Indexed: 12/13/2022] Open
Abstract
Purpose To investigate if apparent diffusion coefficient (ADC) values within primary central nervous system lymphoma correlate with cellularity and proliferative activity in corresponding histological samples. Materials and Methods Echo-planar diffusion-weighted magnetic resonance images obtained from 21 patients with primary central nervous system lymphoma were reviewed retrospectively. Regions of interest were drawn on ADC maps corresponding to the contrast enhancing parts of the tumors. Biopsies from all 21 patients were histologically analyzed. Nuclei count, total nuclei area and average nuclei area were measured. The proliferation index was estimated as Ki-67 positive nuclei divided by total number of nuclei. Correlations of ADC values and histopathologic parameters were determined statistically. Results Ki-67 staining revealed a statistically significant correlation with ADCmin (r = -0.454, p = 0.038), ADCmean (r = -0.546, p = 0.010) and ADCmax (r = -0.515, p = 0.017). Furthermore, ADCmean correlated in a statistically significant manner with total nucleic area (r = -0.500, p = 0.021). Conclusion Low ADCmin, ADCmean and ADCmax values reflect a high proliferative activity of primary cental nervous system lymphoma. Low ADCmean values—in concordance with several previously published studies—indicate an increased cellularity within the tumor.
Collapse
Affiliation(s)
- Stefan Schob
- Department of Neuroradiology, University Hospital Leipzig, Leipzig, Germany
- * E-mail:
| | - Jonas Meyer
- Department of Radiology, Martin Luther University of Halle-Wittenberg, Halle-Wittenberg, Germany
| | - Matthias Gawlitza
- Department of Neuroradiology, University Hospital Leipzig, Leipzig, Germany
| | | | - Wolf Müller
- Department of Neuropathology, University Hospital Leipzig, Leipzig, Germany
| | - Matthias Preuss
- Department of Neurosurgery, University Hospital Leipzig, Leipzig, Germany
| | - Lionel Bure
- Department of Radiology, McGill University Health Center, Montreal General Hospital, Montreal, Canada
| | - Ulf Quäschling
- Department of Neuroradiology, University Hospital Leipzig, Leipzig, Germany
| | | | - Alexey Surov
- Department of Diagnostic and Interventional Radiology, University Hospital Leipzig, Leipzig, Germany
| |
Collapse
|
26
|
Apparent diffusion coefficient measurements in diffusion-weighted magnetic resonance imaging of the anterior mediastinum: inter-observer reproducibility of five different methods of region-of-interest positioning. Eur Radiol 2016; 27:1386-1394. [DOI: 10.1007/s00330-016-4527-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 05/23/2016] [Accepted: 07/21/2016] [Indexed: 12/12/2022]
|
27
|
Priola AM, Priola SM. Considerations about the ability of computed tomography to predict the clinical stage of thymoma. Eur J Cardiothorac Surg 2016; 50:584-5. [PMID: 27044901 DOI: 10.1093/ejcts/ezw080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 02/22/2016] [Indexed: 12/21/2022] Open
Affiliation(s)
| | - Sandro Massimo Priola
- Department of Radiology, San Luigi Gonzaga University Hospital, Orbassano, Torino, Italy
| |
Collapse
|
28
|
Priola AM, Veltri A, Priola SM. Importance of different region-of-interest protocols for the apparent diffusion coefficient measurement of tumors in diffusion-weighted magnetic resonance imaging. J Magn Reson Imaging 2016; 44:1056. [DOI: 10.1002/jmri.25190] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 01/25/2016] [Indexed: 12/12/2022] Open
Affiliation(s)
| | - Andrea Veltri
- Department of Diagnostic Imaging; San Luigi Gonzaga University Hospital; Orbassano (Torino) Italy
| | - Sandro Massimo Priola
- Department of Diagnostic Imaging; San Luigi Gonzaga University Hospital; Orbassano (Torino) Italy
| |
Collapse
|