International Thymic Malignancy Interest Group Classification – The Future of Mediastinal Mass Evaluation using Multidetector Computed Tomography

Abstract

Background: The diagnosis of mediastinal masses is a demanding task as it is like Pandora’s box with diverse masses. Multidetector computed tomography (MDCT), along with intravenous contrast, is the diagnostic technique of choice to diagnose mediastinal masses. Hence, the International Thymic Malignancy Interest Group (ITMIG) uses MDCT as a gold standard for defining mediastinal compartments. Aim and Objectives: The purpose of this study was to ascertain characteristics, the accurate extension of mediastinal masses, and its distribution according to classification by ITMIG and to correlate the fine-needle aspiration cytology/biopsy diagnosis to the findings of the computed tomography (CT) scan where ever possible. Materials and Methods: The present study was conducted at the Radiodiagnosis Department of AVBRH, a Teaching Hospital of DMIHER, Sawangi (Meghe) Wardha. It was a prospective cross-sectional study. A purposive convenience sampling method was used with a sample size of 100 participants needed for 2 years. Results: In the study population, the predominant (63%) participants were male, and the remaining 37 (37.00%) participants were female. Fifteen (15.00%) lesions were in prevascular, 55 (55.00%) were in visceral, 15 (15.00%) were in paravertebral, 8 (8.00%) involved Prevascular + Visceral, 7 (7.00%) lesions involved all three compartments, i.e., Prevascular + Visceral + Paravertebral localization. In the present study, in 94.73% of the masses, the same diagnosis was made by both CT and holoprosencephaly. In 5.27% of the masses, the diagnosis was different. The total diagnostic accuracy was 100% (95% confidence interval 93.73%–100%). Conclusion: CT has a cardinal part in the assessment of different masses in the mediastinum in regards to their characterization, distribution, and distinguishing malignant and benign lesions. The novel mediastinal division system introduced by ITMIG is intended to facilitate uniform communication between health-care professionals and radiologists at cross-sectional imaging.