Abstract
We evaluated the performance of intravoxel incoherent motion (IVIM) parameters for preoperatively predicting the subtype and Masaoka stage of thymic epithelial tumors (TETs). Seventy-seven patients with pathologically confirmed TETs underwent a diffusion weighted imaging (DWI) sequence with 9 b values. Differences in the slow diffusion coefficient (D), fast perfusion coefficient (D), and perfusion fraction (f) IVIM parameters, as well as the multi b-value fitted apparent diffusion coefficient (ADCmb), were compared among patients with low-risk (LRT) and high-risk thymomas (HRT) and thymic carcinomas (TC), and between early stage (stages I and II) and advanced stage (stages III and IV) TET patients. ADCmb, D, and D values were higher in the LRT group than in the HRT or TC group, but did not differ between the HRT and TC groups. The mean ADCmb, D, and D values were higher in the early stage TETs group than the advanced stage TETs group. The f values did not differ among the groups. These results suggest that IVIM DWI could be used to preoperatively predict subtype and Masaoka stage in TET patients.
Highlights
Thymic epithelial tumors (TETs) are relatively rare, accounting for 0.2-1.5 % of all malignancies, they are the most common primary tumor of the anterior mediastinum [1, 2]
We evaluated the performance of intravoxel incoherent motion (IVIM) parameters for preoperatively predicting the subtype and Masaoka stage of thymic epithelial tumors (TETs)
Sixty-five TET cases were staged based on surgical specimens, and the remaining 12 advanced stage patients were staged based on the presence of pleural or pericardium dissimilation or hematogenous metastasis at imaging and confirmatory puncture biopsies
Summary
Thymic epithelial tumors (TETs) are relatively rare, accounting for 0.2-1.5 % of all malignancies, they are the most common primary tumor of the anterior mediastinum [1, 2]. The major prognostic indicators for TETs are tumor invasiveness and histology, which is evaluated using the Masaoka staging system [3] and is an important indicator of candidacy for complete surgical resection. Optimal therapeutic strategies and prognoses for TETs differ depending on pathological type or stage [4], especially because surgery is not always the first step in treatment. It is critical to accurately identify histological type and stage before treatment. Imaging is an important noninvasive technique for the preoperative diagnosis, staging, and follow-up monitoring of TETs [10]. Conventional imaging has shown considerable potential, it relies on qualitative parameters and the presence of many overlapping features, and TET type and stage cannot be accurately assessed using conventional imaging [14]
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