Feasibility of using dynamic contrast-enhanced MRI for differentiating thymic carcinoma from thymic lymphoma based on semi-quantitative and quantitative models

Clin Radiol. 2020 Jul;75(7):560.e19-560.e25. doi: 10.1016/j.crad.2020.02.010. Epub 2020 Mar 17.

Abstract

Aim: To evaluate the value of using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) derived parameters to differentiate thymic carcinoma and thymic lymphoma based on semi-quantitative and quantitative models.

Materials and methods: Twenty-nine pathologically confirmed anterior mediastinum tumours in 29 patients were enrolled in this retrospective study, including 15 thymic carcinoma and 14 lymphoma patients. All the patients underwent pre-treatment mediastinum DCE-MRI. Both semi-quantitative and quantitative parameters were calculated and the volume transfer constant Ktrans, the flux rate constant between extravascular extracellular space and plasma kep, the extravascular extracellular volume fraction ve were obtained based on a modified Tofts model. DCE-MRI derived parameters were compared between thymic carcinoma and thymic lymphoma groups.

Results: Thymic carcinoma had significantly lower kep (p=0.040) and higher ve (p=0.018) than thymic lymphoma; however, there were no significant differences on Ktrans and semi-quantitative parameters between the two groups. ve had the highest area under the curve (cut-off value, 0.282; area under the curve, 0.748; sensitivity, 71.4%; specificity, 80%). The combination of kep and ve could increase the diagnostic performance significantly (area under the curve, 0.752; sensitivity, 57.1%; specificity, 93.3%).

Conclusion: DCE-MRI derived parameters may have value in the differentiating thymic carcinoma and thymic lymphoma.

MeSH terms

  • Adult
  • Contrast Media*
  • Diagnosis, Differential
  • Female
  • Humans
  • Lymphoma / diagnostic imaging*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Sensitivity and Specificity
  • Thymoma / diagnosis
  • Thymoma / diagnostic imaging*
  • Thymus Gland / diagnostic imaging
  • Thymus Neoplasms / diagnosis
  • Thymus Neoplasms / diagnostic imaging*

Substances

  • Contrast Media