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Volume-based quantification using dual-energy computed tomography in the differentiation of thymic epithelial tumours: an initial experience

 Suyon Chang  ;  Jin Hur  ;  Dong Jin Im  ;  Young Joo Suh  ;  Yoo Jin Hong  ;  Hye-Jeong Lee  ;  Young Jin Kim  ;  Kyunghwa Han  ;  Dae Joon Kim  ;  Chang Young Lee  ;  Ha Young Shin  ;  Byoung Wook Choi 
 EUROPEAN RADIOLOGY, Vol.27(5) : 1992-2001, 2017 
Journal Title
Issue Date
Adult ; Aged ; Carcinoma/diagnostic imaging* ; Carcinoma/pathology ; Contrast Media ; Female ; Humans ; Image Processing, Computer-Assisted ; Iopamidol ; Male ; Middle Aged ; Multidetector Computed Tomography ; Neoplasms, Glandular and Epithelial/diagnostic imaging* ; Neoplasms, Glandular and Epithelial/pathology ; Prospective Studies ; Thymoma/diagnostic imaging* ; Thymoma/pathology ; Thymus Neoplasms/diagnostic imaging* ; Thymus Neoplasms/pathology ; Tomography, X-Ray Computed/methods ; Tumor Burden
Dual-energy computed tomography ; Iodine concentration ; Mediastinal mass ; Thymic carcinoma ; Thymoma
OBJECTIVES: To investigate the diagnostic value of dual-energy computed tomography (DECT) in differentiating between low- and high-risk thymomas and thymic carcinomas.

MATERIALS: Our institutional review board approved this study, and patients provided informed consent. We prospectively enrolled 37 patients (20 males, mean age: 55.6 years) with thymic epithelial tumour. All patients underwent DECT. For quantitative analysis, two reviewers measured the following tumour parameters: CT attenuation value in contrast Hounsfield units (CHU), iodine-related HU and iodine concentration (mg/ml). Pathological results confirmed the final diagnosis.

RESULTS: Of the 37 thymic tumours, 23 (62.2 %) were low-risk thymomas, five (13.5 %) were high-risk thymomas and nine (24.3 %) were thymic carcinomas. According to quantitative analysis, iodine-related HU and iodine concentration were significantly different among low-risk thymomas, high-risk thymomas and thymic carcinomas (median: 29.78 HU vs. 14.55 HU vs. 19.95 HU, p = 0.001 and 1.92 mg/ml vs. 0.99 mg/ml vs. 1.18 mg/ml, p < 0.001, respectively).

CONCLUSION: DECT using a quantitative analytical method based on iodine concentration measurement can be used to differentiate among thymic epithelial tumours using single-phase scanning.

KEY POINTS: • IHU and IC were lower in high-risk thymomas/carcinomas than in low-risk thymomas • IHU and IC were lower in advanced-stage thymomas than in early-stage thymomas • Dual-energy CT helps differentiate among thymic epithelial tumours.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dae Joon(김대준)
Kim, Young Jin(김영진) ORCID logo https://orcid.org/0000-0002-6235-6550
Suh, Young Joo(서영주) ORCID logo https://orcid.org/0000-0002-2078-5832
Shin, Ha Young(신하영) ORCID logo https://orcid.org/0000-0002-4408-8265
Lee, Chang Young(이창영)
Lee, Hye Jeong(이혜정) ORCID logo https://orcid.org/0000-0003-4349-9174
Im, Dong Jin(임동진) ORCID logo https://orcid.org/0000-0001-8139-5646
Chang, Su Yon(장수연)
Choi, Byoung Wook(최병욱) ORCID logo https://orcid.org/0000-0002-8873-5444
Hur, Jin(허진) ORCID logo https://orcid.org/0000-0002-8651-6571
Hong, Yoo Jin(홍유진) ORCID logo https://orcid.org/0000-0002-7276-0944
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