| 1. Araki T, Nishino M, Gao W, et al. Anterior Mediastinal Masses in the Framingham Heart Study: Prevalence and CT Image Characteristics. European Journal of Radiology Open. 2:26-31, 2015. |
Review/Other-Dx |
2571 patients |
To investigate the prevalence and CT image characteristics of anterior mediastinal masses in a population-based cohort and their association with the demographics of the participants. |
Of 2571, 23 participants (0.9%, 95% CI: 0.6 to 1.3) had anterior mediastinal masses on CT. The most common CT characteristics were oval shape, lobular contour, and midline location, showing soft tissue density (median 32.1 HU). Fat content was detected in a few cases (9%, 2/23). Six out of eight masses with available prior cardiac CT scans demonstrated an interval growth over a median period of 6.5 years. No risk factors for anterior mediastinal masses were detected among participants' demographics, including age, sex, BMI, and cigarette smoking. |
4 |
| 2. Yoon SH, Choi SH, Kang CH, Goo JM. Incidental Anterior Mediastinal Nodular Lesions on Chest CT in Asymptomatic Subjects. Journal of Thoracic Oncology: Official Publication of the International Association for the Study of Lung Cancer. 13(3):359-366, 2018 03. |
Observational-Dx |
56,358 patients |
To investigate the prevalence and characteristics of nodular lesions in the anterior mediastinum that had been found incidentally on screening chest computed tomography (CT) in asymptomatic subjects. |
Of the 56,358 participants, 413 (0.73%) had lesions (95% confidence interval: 0.66-0.80%); the prevalence increased with age (p <0.001) and a history of malignancy (p = 0.005). Of the lesions, 85.2% were smaller than 2 cm, 61.3% were round, and 80.2% had CT attenuation higher than 20 Hounsfield units. Among 51 proven cases, 39 lesions (76.9%) were benign and 12 (23.1%) were malignant. The standardized prevalence ratio for thymic epithelial tumor was 2.04 (95% confidence interval: 1.01-3.42). Of 11 resected thymic epithelial tumors, five were carcinomas, 10 were stage I or II, and all were completely resected without recurrence. Of the 237 unconfirmed cases with a follow-up CT scan, 82.2% were stable, 8.9% had increased, and the other 8.9% had decreased. |
2 |
| 3. Hall WB, Truitt SG, Scheunemann LP, et al. The prevalence of clinically relevant incidental findings on chest computed tomographic angiograms ordered to diagnose pulmonary embolism. Archives of Internal Medicine. 169(21):1961-5, 2009 Nov 23. |
Review/Other-Dx |
141 patients |
To determine the prevalence and management implications of incidental findings on chest CTAs ordered to assess for PE. |
Pulmonary embolism was found in 55 of 589 CTAs (9%). A total of 195 CTAs (33%) had findings that supported alternative diagnoses. A total of 141 patients (24%) had a new incidental finding that required diagnostic follow-up, including 73 patients (13%) with a new pulmonary nodule and 51 patients (9%) with new adenopathy. Using current clinical guidelines, follow-up computed tomography or another procedure would be recommended for 96% of patients with new incidental pulmonary nodules. |
4 |
| 4. Henschke CI, Lee IJ, Wu N, et al. CT screening for lung cancer: prevalence and incidence of mediastinal masses. Radiology. 239(2):586-90, 2006 May. |
Review/Other-Dx |
9263 patients |
To determine the frequency and natural course of mediastinal masses in asymptomatic people at high risk for lung cancer who were undergoing computed tomographic (CT) screening. |
Of the 9263 individuals, 71 had a mediastinal mass seen at baseline screening (prevalence of 0.77%). Of the 71 masses, 41 were thymic, 16 were thyroidal, two were esophageal cancers, six were tracheal-esophageal diverticula, and six were other masses. Among the 11 126 annual repeat screenings, only one new mediastinal mass was identified (incidence of 0.01%). This suggests a long average duration for mediastinal masses in asymptomatic people. Among the 41 thymic masses, five were larger than 3.0 cm in diameter, and all five were resected; of these five, one was a thymic carcinoma and four were noninvasive thymomas. Of the remaining 36 thymic masses, 25 were evaluated at follow-up CT 1 year later: Five had increased in diameter, two had decreased, and 18 remained unchanged. All 16 thyroid masses were due to goiter; none of these were changed at follow-up CT 1 year later. |
4 |
| 5. Neumann HP, Pawlu C, Peczkowska M, et al. Distinct clinical features of paraganglioma syndromes associated with SDHB and SDHD gene mutations. JAMA. 292(8):943-51, 2004 Aug 25. |
Observational-Dx |
417 patients |
To determine the differences in clinical features in carriers of SDHB mutations and SDHD mutations. |
A total of 49 (12%) of 417 registrants carried SDHB or SDHD mutations. In addition, 28 SDHB and 23 SDHD mutation carriers were newly detected among relatives of these carriers. Comparison of 53 SDHB and 47 SDHD total mutation carriers showed similar ages at diagnosis but differences in penetrance and of tumor manifestations. Head and neck paragangliomas (10/32 vs 27/34, respectively, P<.001) and multifocal (9/32 vs 25/34, respectively, P<.001) tumors were more frequent in carriers of SDHD mutations. In contrast, SDHB mutation carriers have an increased frequency of malignant disease (11/32 vs 0/34, P<.001). Renal cell cancer was observed in 2 SDHB mutation carriers and papillary thyroid cancer in 1 SDHB mutation carrier and 1 SDHD mutation carrier. |
1 |
| 6. Gimm O, Armanios M, Dziema H, Neumann HP, Eng C. Somatic and occult germ-line mutations in SDHD, a mitochondrial complex II gene, in nonfamilial pheochromocytoma. Cancer Res. 60(24):6822-5, 2000 Dec 15. |
Review/Other-Dx |
18 patients |
To determine whether (Succinate dehydrogenase D) SDHD plays a role in the development of sporadic pheochromocytomas and performed a mutation and deletion analysis of SDHD. |
No results stated in the abstract. |
4 |
| 7. Dalmau J, Tuzun E, Wu HY, et al. Paraneoplastic anti-N-methyl-D-aspartate receptor encephalitis associated with ovarian teratoma. Ann Neurol. 61(1):25-36, 2007 Jan. |
Review/Other-Dx |
12 patients |
To report the autoantigens of a new category of treatment-responsive paraneoplastic encephalitis. |
Twelve women (14-44 years) developed prominent psychiatric symptoms, amnesia, seizures, frequent dyskinesias, autonomic dysfunction, and decreased level of consciousness often requiring ventilatory support. All had serum/cerebrospinal fluid antibodies that predominantly immunolabeled the neuropil of hippocampus/forebrain, in particular the cell surface of hippocampal neurons, and reacted with NR2B (and to a lesser extent NR2A) subunits of the NMDAR. NR2B binds glutamate and forms heteromers (NR1/NR2B or NR1/NR2A/NR2B) that are preferentially expressed in the adult hippocampus/forebrain. Expression of functional heteromers (not single subunits) was required for antibody binding. Eleven patients had teratoma of the ovary (six mature) and one a mature teratoma in the mediastinum; five of five tumors examined contained nervous tissue that strongly expressed NR2 subunits and reacted with patients' antibodies. Tumor resection and immunotherapy resulted in improvement or full recovery of eight of nine patients (paralleled by decreased antibody titers); two of three patients without tumor resection died of neurological deterioration. Autopsies showed extensive microgliosis, rare T-cell infiltrates, and neuronal degeneration predominantly involving, but not restricted to, the hippocampus. |
4 |
| 8. Carter BW, Tomiyama N, Bhora FY, et al. A modern definition of mediastinal compartments. J Thorac Oncol. 9(9 Suppl 2):S97-101, 2014 Sep. |
Review/Other-Dx |
N/A |
To describe a modern, computed tomography-based mediastinal division scheme, which has been accepted by the International Thymic Malignancy Interest Group as a new standard. |
No results stated in the abstract. |
4 |
| 9. Thacker PG, Mahani MG, Heider A, Lee EY. Imaging Evaluation of Mediastinal Masses in Children and Adults: Practical Diagnostic Approach Based on A New Classification System. [Review]. Journal of Thoracic Imaging. 30(4):247-67, 2015 Jul. |
Review/Other-Dx |
N/A |
To evaluate the mediastinal masses in children and adults. |
No results stated in the abstract. |
4 |
| 10. Carter BW, Benveniste MF, Madan R, et al. ITMIG Classification of Mediastinal Compartments and Multidisciplinary Approach to Mediastinal Masses. [Review]. Radiographics. 37(2):413-436, 2017 Mar-Apr. |
Review/Other-Dx |
N/A |
To determine the International Thymic Malignancy Interest Group (ITMIG) Classification of Mediastinal Compartments and Multidisciplinary approach to Mediastinal Masses |
No results stated in the abstract. |
4 |
| 11. Roden AC, Fang W, Shen Y, et al. Distribution of Mediastinal Lesions Across Multi-Institutional, International, Radiology Databases. J Thorac Oncol 2020;15:568-79. |
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| 12. Whitten CR, Khan S, Munneke GJ, Grubnic S. A diagnostic approach to mediastinal abnormalities. [Review] [17 refs]. Radiographics. 27(3):657-71, 2007 May-Jun. |
Review/Other-Dx |
N/A |
To determine a diagnostic approach to mediastinal abnormalities. |
No results stated in the abstract. |
4 |
| 13. McErlean A, Huang J, Zabor EC, Moskowitz CS, Ginsberg MS. Distinguishing benign thymic lesions from early-stage thymic malignancies on computed tomography. Journal of Thoracic Oncology: Official Publication of the International Association for the Study of Lung Cancer. 8(7):967-73, 2013 Jul. |
Observational-Dx |
66 patients |
To identify CT features that distinguish benign thymic lesions from early-stage malignant thymic neoplasms. |
Thirty-eight malignant (58%) and 28 benign thymic lesions (42%) were included. Patients with benign thymic tumors were significantly younger (median age, 49.5 years) than patients with malignant tumors (60.0 years; p = 0.007). Malignant tumors were larger in short-axis dimension (p = 0.028) and more frequently in a nonmidline location in the anterior mediastinum (p = 0.029). Intralesional fat was seen exclusively in benign masses (p = 0.002). Seven benign tumors (25%) and one malignant tumor (2.6%) had a triangular thymic shape (p = 0.023). In multivariate analysis, lower age, smaller short-axis dimension, and lack of infiltration of the mediastinal fat were significant independent predictors of benign pathologic results. |
2 |
| 14. Gezer NS, Balci P, Tuna KC, Akin IB, Baris MM, Oray NC. Utility of chest CT after a chest X-ray in patients presenting to the ED with non-traumatic thoracic emergencies. American Journal of Emergency Medicine. 35(4):623-627, 2017 Apr. |
Observational-Dx |
500 patients |
To evaluate the utility of chest CT after a chest X-ray in patients presenting to the ED with non-traumatic thoracic emergencies, and to determine if the diagnosis and management decision changed after CT. |
The chest X-ray and CT image findings were concordant in 49.2% of the 500 patients and this concordance was negatively correlated with patient age. Leading diagnosis and management decisions based on the chest radiograph changed after CT in 35.4% of the study group and this finding was also correlated with age. In 55% of 205 patients, pneumonic infiltrations were undiagnosed with radiography. Pulmonary edema was the most specific (93.3%) and sensitive (85.4%) radiography finding. Posteroanterior chest radiographs taken in the upright position had higher concordance with CT than anteroposterior (AP) radiographs taken in the supine position. |
2 |
| 15. Tomiyama N, Honda O, Tsubamoto M, et al. Anterior mediastinal tumors: diagnostic accuracy of CT and MRI. European Journal of Radiology. 69(2):280-8, 2009 Feb. |
Observational-Dx |
127 patients |
To compare the diagnostic accuracy for anterior mediastinal tumors among CT, MRI, and both CT and MRI, and to determine the optimal CT and MRI procedures for the diagnosis of anterior mediastinal tumors. |
The two observers made a correct first-choice diagnosis in an average of 78 (61%) of 127 cases on CT, 71 (56%) of 127 cases on MRI, and 85.5 (67%) of 127 cases on both CT and MRI. These included 83% cases of thymoma on CT, 84% on MRI, and 85% on both CT and MRI; 38% cases of thymic carcinoma on CT and 13% on MRI, and 33% on both CT and MRI; 46% cases of thymic cyst on CT and 71% on MRI, and 63% on both CT and MRI; 58% cases of mature teratoma and 38% on MRI, and 78% on both CT and MRI; 35% cases of malignant germ cell tumor on CT and 27% on MRI, and 31% on both CT and MRI; and 55% cases of malignant lymphoma on CT and 43% on MRI, and 61% on both CT and MRI. There were significant differences between the diagnostic accuracy by CT and MRI in the cases with both thymic cysts and thymic carcinoma (p<0.05). |
1 |
| 16. Date H.. Diagnostic strategies for mediastinal tumors and cysts. [Review] [14 refs]. Thoracic Surgery Clinics. 19(1):29-35, vi, 2009 Feb. |
Review/Other-Dx |
N/A |
To describe diagnostic strategies for Mediastinal Tumors and Cysts. |
No results stated in the abstract. |
4 |
| 17. American College of Radiology. ACR Appropriateness Criteria®: Radiologic Management of Thoracic Nodules and Masses. Available at: https://acsearch.acr.org/docs/69343/Narrative/. |
Review/Other-Dx |
N/A |
Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for a specific clinical condition. |
No abstract available. |
4 |
| 18. McAdams HP, Kirejczyk WM, Rosado-de-Christenson ML, Matsumoto S. Bronchogenic cyst: imaging features with clinical and histopathologic correlation. Radiology. 217(2):441-6, 2000 Nov. |
Review/Other-Dx |
68 patients (58 mediastinal and 10 extramediastinal cysts. |
To characterize the imaging features of bronchogenic cysts. |
There were 58 mediastinal and 10 extramediastinal cysts. At CT (n = 62), 60 cysts were sharply marginated with smooth (n = 35) or lobulated (n = 25) borders. Twenty-five cysts were of water attenuation, 25 were of soft-tissue attenuation, two were air filled, two had an air-fluid level, and two had dependent milk of calcium. On T1-weighted MR images (n = 23), 18 cysts were hyperintense and five were isointense to cerebrospinal fluid. On T2-weighted MR images (n = 18), 17 cysts were isointense or hyperintense to cerebrospinal fluid. Of the 25 soft-tissue-attenuation lesions at CT, 11 appeared cystic because of internal homogeneity, lack of internal enhancement, mural enhancement, and characteristic location. Fourteen appeared solid based on morphology and attenuation. MR imaging of nine of the latter showed marked hyperintensity on T2-weighted images. |
4 |
| 19. Molina PL, Siegel MJ, Glazer HS. Thymic masses on MR imaging. AJR. American Journal of Roentgenology. 155(3):495-500, 1990 Sep. |
Review/Other-Dx |
N/A |
To identify Thymic masses using MR imaging. |
No results stated in the abstract. |
4 |
| 20. Ackman JB, Wu CC. MRI of the thymus. [Review]. AJR. American Journal of Roentgenology. 197(1):W15-20, 2011 Jul. |
Review/Other-Dx |
N/A |
To illustrate the role of MRI as a problem-solving modality in the thorax by highlighting its strength in distinguishing surgical from nonsurgical thymic masses. |
No results stated in the abstract. |
4 |
| 21. Ackman JB.. MR Imaging of Mediastinal Masses. [Review]. Magnetic Resonance Imaging Clinics of North America. 23(2):141-64, 2015 May. |
Review/Other-Dx |
N/A |
To illustrate the role of MR imaging for Mediastinal Masses. |
No results stated in the abstract. |
4 |
| 22. Inaoka T, Takahashi K, Mineta M, et al. Thymic hyperplasia and thymus gland tumors: differentiation with chemical shift MR imaging. Radiology. 243(3):869-76, 2007 Jun. |
Observational-Dx |
41 patients |
To prospectively evaluate chemical shift magnetic resonance (MR) imaging for differentiating thymic hyperplasia from tumors of the thymus gland. |
The thymus gland had homogeneous signal intensity in all 23 patients in the hyperplasia group and in 12 of the 18 patients in the tumor group. The mean CSR (+/- standard deviation) was 0.614 +/- 0.130 in the hyperplasia group and 1.026 +/- 0.039 in the tumor group. Mean CSRs in the patients with a hyperplastic thymus and Graves disease, rebound thymic hyperplasia, thymoma, invasive thymoma, thymic cancer, and malignant lymphoma were 0.594 +/- 0.120, 0.688 +/- 0.154, 1.033 +/- 0.043, 1.036 +/- 0.040, 1.020 +/- 0.044, and 0.997 +/- 0.010, respectively. The difference in CSR between the hyperplasia and tumor groups was significant (P<.001). Mean CSRs in the hyperplasia subgroups were lower than those in the tumor subgroups (P<.001). All hyperplasia group patients had an apparent decrease in thymus gland signal intensity at chemical shift MR imaging; no tumor group patients had a decrease in thymus gland signal intensity. |
2 |
| 23. Priola AM, Priola SM, Giraudo MT, et al. Chemical-shift and diffusion-weighted magnetic resonance imaging of thymus in myasthenia gravis: usefulness of quantitative assessment. Invest Radiol. 50(4):228-38, 2015 Apr. |
Observational-Dx |
87 subjects |
To prospectively investigate the usefulness of chemical-shift and diffusion-weighted (DW) magnetic resonance imaging (MRI) in patients with myasthenia gravis (MG) for distinguishing thymic lymphoid hyperplasia (TLH), normal thymus (NT), and thymoma (THY) by using the signal intensity index (SII) and the apparent diffusion coefficient (ADC). |
The interreader agreement was excellent (intraclass correlation coefficient: SII, 0.998; ADC, 0.944). For CS-MRI, the mean (SD) SII value was significantly different between the groups (A, 36.37% [12.60%]; B, -0.06% [3.85%]; P < 0.001). No overlap in indexes was found with sensitivity, specificity, and cut point of 100%, 100%, and 6.37%, respectively. Conversely, the mean SII value was not different between the subgroups of each group (A, P = 0.607; B, P = 0.252). For DW-MRI, the mean (SD) ADC values were significantly different between the groups (A, 1.92 [0.21] × 10·mm/s; B, 1.36 [0.33] × 10 mm/s; P < 0.001) and between the subgroups of group A (TLH, 1.86 [0.17] × 10 mm/s; NT, 2.10 [0.23] × 10 mm/s; P = 0.002), although overlapped values were found. The AUROC of ADC in discriminating TLH/NT from THY was 0.931 (95% confidence interval, 0.863-0.998), and the optimal cut point for this distinction was 1.625 × 10 mm/s (Youden index, J = 0.760) with sensitivity of 96.8% and specificity of 79.2%. For the subgroups of group A, the AUROC of ADC in discriminating NT from TLH was 0.794 (95% confidence interval, 0.666-0.923), and the optimal cut point for this distinction was 2.01 × 10 mm/s (Youden index, J = 0.458) with sensitivity of 66.7% and specificity of 79.2%. |
1 |
| 24. Ackman JB, Verzosa S, Kovach AE, et al. High rate of unnecessary thymectomy and its cause. Can computed tomography distinguish thymoma, lymphoma, thymic hyperplasia, and thymic cysts?. European Journal of Radiology. 84(3):524-533, 2015 Mar. |
Observational-Dx |
160 thymectomy cases (85 women, 75 men) |
To determine the non-therapeutic thymectomy rate in a recent six-year consecutive thymectomy cohort, the etiology of these unnecessary thymectomies, and the differentiating CT features of thymoma, lymphoma, thymic hyperplasia, and thymic cysts. |
The non-therapeutic thymectomy rate of 43.8% (70/160) was largely secondary to concern for thymoma and was comprised of lymphoma (54.3%, 38/70), thymic bed cysts (24.3%, 17/70), thymic hyperplasia (17.1%, 12/70), and reactive or atrophic tissue (4.3%, 3/70). Among these four lesions, there were significant differences in location with respect to midline, morphology, circumscription, homogeneity of attenuation, fatty intercalation, coexistent lymphadenopathy, overt pericardial invasion, and mass effect (p<0.001). True thymic cysts ranged in attenuation from -20 to 58Hounsfield units (HU), with a mean attenuation of 23HU. |
2 |
| 25. Ackman JB.. Corrigendum to 'High rate of unnecessary thymectomy and its cause. Can computed tomography distinguish thymoma, lymphoma, thymic hyperplasia, and thymic cysts?' [EURR 84 (3) (2015) 524-533]. Eur J Radiol. 90:262-263, 2017 05. |
Review/Other-Dx |
N/A |
No abstract available. |
No results stated in the abstract. |
4 |
| 26. Kent MS, Wang T, Gangadharan SP, Whyte RI. What is the prevalence of a "nontherapeutic" thymectomy?. Ann Thorac Surg. 97(1):276-82; discussion 82, 2014 Jan. |
Observational-Dx |
1,306 patients |
To determine the prevalence of a "nontherapeutic" thymectomy. |
A total of 1,306 patients were identified. Overall, 72.2% (n = 943) of thymectomies were therapeutic and 27.8% (n = 363) were nontherapeutic. The most common diagnosis in the nontherapeutic group was thymic hyperplasia (n = 174). Mortality (0.32% versus 0%; p = 0.083) and overall complication rates (25% versus 17%; p < 0.001) were higher in the therapeutic group. Patients in the nontherapeutic group were younger (median age, 41 versus 56 years; p < 0.001) and more likely to undergo a video-assisted thoracoscopic surgery thymectomy (28% versus 19%; p = 0.085). |
2 |
| 27. Ackman JB, Gaissert HA, Lanuti M, et al. Impact of Nonvascular Thoracic MR Imaging on the Clinical Decision Making of Thoracic Surgeons: A 2-year Prospective Study. Radiology. 280(2):464-74, 2016 08. |
Review/Other-Dx |
134 nonvascular thoracic MR imaging examinations |
To determine the impact of nonvascular thoracic magnetic resonance (MR) imaging on the clinical decision making and diagnostic certainty of thoracic surgeons. |
A total of 99 pre- and post-test surveys were completed. Most MR imaging studies (64 of 99 [65%]) were requested because of indeterminate computed tomographic findings. The use of MR imaging significantly reduced the number of planned surgical interventions (P < .001), modified the surgical approach in 54% (14 of 26) of surgical cases, and increased surgeon comfort with the patient management plan in 95% (94 of 99) of cases. Increased diagnostic certainty as a result of MR imaging was highly significant (P < .0001). In 21% (21 of 99) of cases, definitive MR imaging results warranted no further follow-up or clinical care. Conclusion In appropriate cases, assessment with nonvascular thoracic MR imaging substantially affects the clinical decision making and diagnostic certainty of thoracic surgeons. (©) RSNA, 2016 Online supplemental material is available for this article. An earlier incorrect version of this article appeared online. This article was corrected on May 2, 2016 |
4 |
| 28. Carter BW, Okumura M, Detterbeck FC, Marom EM. Approaching the patient with an anterior mediastinal mass: a guide for radiologists. [Review]. Journal of Thoracic Oncology: Official Publication of the International Association for the Study of Lung Cancer. 9(9 Suppl 2):S110-8, 2014 Sep. |
Review/Other-Dx |
N/A |
To discuss the structure for radiologist to facilitate evaluation of patients with anterior mediastinal tumors. |
No results stated in the abstract. |
4 |
| 29. Carter BW, Marom EM, Detterbeck FC. Approaching the patient with an anterior mediastinal mass: a guide for clinicians. [Review]. Journal of Thoracic Oncology: Official Publication of the International Association for the Study of Lung Cancer. 9(9 Suppl 2):S102-9, 2014 Sep. |
Review/Other-Dx |
N/A |
To develop a structured approach for clinicians to evaluate patients with anterior mediastinal masses. |
No results stated in the abstract. |
4 |
| 30. Manson DE. Magnetic resonance imaging of the mediastinum, chest wall and pleura in children. [Review]. Pediatric Radiology. 46(6):902-15, 2016 May.Pediatr Radiol. 46(6):902-15, 2016 May. |
Review/Other-Dx |
N/A |
To discuss the use of magnetic resonance imaging of the mediastinum in children. |
No results stated in the abstract. |
4 |
| 31. Takahashi K, Al-Janabi NJ. Computed tomography and magnetic resonance imaging of mediastinal tumors. [Review]. Journal of Magnetic Resonance Imaging. 32(6):1325-39, 2010 Dec. |
Review/Other-Dx |
N/A |
To describe the clinical, pathological, and imaging findings of mediastinal tumors with focus on thymic hyperplasia, thymic epithelial tumors, and germ cell tumors, malignant lymphoma, and various cystic masses. |
No results stated in the abstract. |
4 |
| 32. Ottlakan A, Borda B, Morvay Z, Maraz A, Furak J. The Effect of Diagnostic Imaging on Surgical Treatment Planning in Diseases of the Thymus. [Review]. Contrast Media & Molecular Imaging. 2017:9307292, 2017. |
Review/Other-Dx |
N/A |
To review the advantages and backdrops of different imaging techniques used in the diagnosis of benign and malignant thymic conditions, with emphasis on differential imaging of thymic hyperplasia (TH), ectopic thymic tissue (ETT), and thymic epithelial tumors (TETs), with special attention to the importance of MR imaging according to the new TNM classification of thymic epithelial tumors. |
No results stated in the abstract. |
4 |
| 33. Kauczor HU, Ley S. Thoracic magnetic resonance imaging 1985 to 2010. J Thorac Imaging. 25(1):34-8, 2010 Feb. |
Review/Other-Dx |
N/A |
N/A |
No results stated in the abstract. |
4 |
| 34. Chang CA, Pattison DA, Tothill RW, et al. (68)Ga-DOTATATE and (18)F-FDG PET/CT in Paraganglioma and Pheochromocytoma: utility, patterns and heterogeneity. Cancer Imaging. 16(1):22, 2016 Aug 17. |
Observational-Dx |
23 patients |
To report our experience using both Ga-68 DOTATATE and F-18 FDG PET/CT imaging in patients with PGLs and PCCs. |
DOTATATE and FDG were positive at most sites of disease (96.2 % vs 91.4 %), although uptake intensity was significantly higher on DOTATATE with a median SUV of 21 compared to 12.5 for FDG (p?<?0.001). SUVmax on F-18 FDG was significantly higher (p?<?0.001) in clinically aggressive cases. I-123/I-124 MIBG detected fewer lesions (30.4 %). |
4 |
| 35. Ferone D, Montella L, De Chiara A, Hofland LJ, Lamberts SW, Palmieri G. Somatostatin receptor expression in thymic tumors. Front Biosci (Landmark Ed). 14:3304-9, 2009 Jan 01. |
Review/Other-Dx |
14 pats |
To discuss the measurement of SSR subtype (sst)2A and sst3 expression by immunohistochemistry (IHC) in 14 thymic tumors previously studied by SSR scintigraphy (SRS). |
SRS was positive in 13 out of 14 patients. In 4 cases, there were at least two sites of abnormal radioligand uptake in the chest, whereas in the other 9 patients there was a single area of uptake. The degree of (111In-DTPA0)octreotide uptake varied greatly among the patients. |
4 |
| 36. Ferone D, van Hagen MP, Kwekkeboom DJ, et al. Somatostatin receptor subtypes in human thymoma and inhibition of cell proliferation by octreotide in vitro. J Clin Endocrinol Metab. 85(4):1719-26, 2000 Apr. |
Observational-Dx |
4 patients (4 thymuses) |
To describe the in vivo and in vitro, functional SS-binding sites in a human thymoma. |
A high uptake of [111In-DTPA-D-Phe1]octreotide was observed in the chest of a patient with myasthenia gravis due to a cortical thymoma. Specific binding of [125I-Tyr11] SS-14 was found on a membrane preparation of the surgically removed thymoma. Scatchard analysis showed high affinity binding sites (Kd, 47.5 +/- 2.5 pmol/L) with low maximum binding capacity (23.5 +/- 2.5 fmol/mg membrane protein). RT-PCR analysis showed the presence of sst1, sst2A, and a predominant sst3 messenger RNA (mRNA) expression in the tumor tissue. Primary cultured tumor cells expressed sst3 mRNA only. In contrast to the normal thymus, SS mRNA was not expressed. By immunohistochemistry, the tumor cells highly expressed sst3 receptors, weakly expressed sst1 receptors, and showed no immunostaining for sst2A receptors. sst2A immunoreactivity was found in the stromal compartment of the tumor, particularly on the endothelium of small intratumoral blood vessels. In primary cultured tumor cells, both SS and octreotide (10 nmol/L) significantly inhibited [3H]thymidine incorporation by 40.6% and 43.2%, respectively |
2 |
| 37. Ferone D, van Hagen PM, van Koetsveld PM, et al. In vitro characterization of somatostatin receptors in the human thymus and effects of somatostatin and octreotide on cultured thymic epithelial cells. Endocrinology. 140(1):373-80, 1999 Jan. |
Observational-Dx |
7 patients (seven thymuses) |
To investigate the Somatostatin (SS) distribution and SS receptors (SS-R) expression pattern in the normal human thymus using autoradiography, membrane homogenate binding studies, and RT-PCR. |
We investigated the SS distribution and SS-R expression pattern in the normal human thymus using autoradiography, membrane homogenate binding studies, and RT-PCR. In addition, the effect of SS and octreotide on growth of cultured thymic epithelial cells (TEC) was studied. By autoradiography, binding of [125I-Tyr0]-SS-28 and [125I-Tyr3]-octreotide was detected in all seven thymuses studied. Specific [125I-Tyr3]-octreotide binding was shown on membrane preparations from thymuses, while not from cultured thymocytes. RT-PCR showed the expression of sst1, sst2A and sst3 messenger RNA (mRNA) in the thymic tissue, whereas sst1 and sst2A mRNAs were found in isolated TEC. SS mRNA was present in thymic tissue and in isolated TEC. SS and octreotide significantly inhibited 3H-thymidine incorporation in 3 of 3 and 6 of 6 TEC cultures, respectively. The percent inhibition ranged from 38.8 to 66.8% for SS and from 19.1 to 59.5% for octreotide. In conclusion, SS mRNA and sst1, sst2A, and sst3 mRNAs are expressed in the normal human thymus. Cultured TEC selectively express sst1 and sst2A mRNA and respond in vitro to SS and octreotide administration with an inhibition of cell proliferation. These data suggest a paracrine/autocrine role of SS and its receptors in the regulation of cell growth in thymic microenvironment. |
2 |
| 38. Buckley JA, Stark P. Intrathoracic mediastinal thyroid goiter: imaging manifestations. AJR Am J Roentgenol. 173(2):471-5, 1999 Aug. |
Review/Other-Dx |
N/A |
N/A |
No results stated in the abstract. |
4 |
| 39. Bronn LJ, Paquelet JR, Tetalman MR. Intrathoracic extramedullary hematopoiesis: appearance on 99mTc sulfur colloid marrow scan. AJR Am J Roentgenol. 134(6):1254-5, 1980 Jun. |
Review/Other-Dx |
N/A |
N/A |
No results stated in the abstract. |
4 |
| 40. Moeller KH, Rosado-de-Christenson ML, Templeton PA. Mediastinal mature teratoma: imaging features. AJR Am J Roentgenol. 169(4):985-90, 1997 Oct. |
Review/Other-Dx |
66 patients |
To characterize the cross-sectional imaging features of mediastinal mature teratomas. |
Forty-six patients presented with symptoms, predominantly chest pain, dyspnea, and cough. Twenty patients were asymptomatic. Fifty-four tumors were found in the anterior mediastinum, two in the posterior mediastinum, one in the middle mediastinum, and nine in multiple compartments. CT studies (n = 66) showed masses of heterogeneous attenuation with varying combinations of soft tissue, fluid, fat, and calcium. Soft-tissue attenuation was observed in 66 tumors (100%), fluid in 58 tumors (88%), fat in 50 tumors (76%), and calcification in 35 tumors (53%). The most frequent combination of attenuations was soft tissue, fluid, fat, and calcium, which was noted in 26 masses (39%). The combination of soft tissue, fluid, and fat was seen in 16 tumors (24%); and the combination of soft tissue and fluid was seen in 10 tumors (15%). Fat-fluid levels were seen in seven masses (11%). |
4 |
| 41. Lee SH, Hur J, Kim YJ, Lee HJ, Hong YJ, Choi BW. Additional value of dual-energy CT to differentiate between benign and malignant mediastinal tumors: an initial experience. European Journal of Radiology. 82(11):2043-9, 2013 Nov. |
Observational-Dx |
10 patients |
To investigate the feasibility of dual-energy computed tomography (DECT) in differentiating malignant from benign mediastinal tumors. |
10 patients (40%) had benign pathology, while 15 (60%) had malignant pathology. The iodine concentration measurements were significantly different between benign and malignant tumors both in the early phase (1.38 mg/ml vs. 2.41 mg/ml, p=0.001) and in the delayed phase (1.52 mg/ml vs. 2.84 mg/ml, p=0.001), while mean attenuation values were not significantly different in both phases (57.8 HU vs. 69.1 HU, p=0.067 and 67.4 HU vs. 78.4 HU, p=0.086, respectively). |
2 |
| 42. Lee SH, Yoon SH, Nam JG, et al. Distinguishing between Thymic Epithelial Tumors and Benign Cysts via Computed Tomography. Korean J Radiol. 20(4):671-682, 2019 Apr. |
Observational-Dx |
262 patients |
To investigate whether computed tomography (CT) and fluorine-18-labeled fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) may be applied to distinguish thymic epithelial tumors (TETs) from benign cysts in the anterior mediastinum. |
The multivariate analysis showed that post-contrast attenuation of 60 Hounsfield unit or higher (odds ratio [OR], 12.734; 95% confidence interval [CI], 2.506-64.705; p = 0.002) and the presence of protrusion from the mediastinal pleura (OR, 9.855; 95% CI, 1.749-55.535; p = 0.009) were the strongest CT predictors for TETs. SUVmax was significantly higher in TETs than in cysts (5.3 ± 2.4 vs. 1.1 ± 0.3; p < 0.001). After being informed of the study findings, the readers' area under the curve improved from 0.872-0.955 to 0.949-0.999 (p = 0.066-0.149). Inter-observer kappa values for protrusion were 0.630-0.941. |
2 |
| 43. Gross JL, Rosalino UA, Younes RN, Haddad FJ, Silva RA, Rocha AB. Characteristics associated with complete surgical resection of primary malignant mediastinal tumors. Jornal Brasileiro De Pneumologia: Publicacao Oficial Da Sociedade Brasileira De Pneumologia E Tisilogia. 35(9):832-8, 2009 Sep. |
Review/Other-Dx |
42 patients |
To identify preoperative characteristics associated with complete surgical resection of primary malignant mediastinal tumors. |
The surgical resection was considered complete in 69.1% of the patients. Cases of incomplete resection were attributed to invasion of the following structures: large blood vessels (4 cases); the superior vena cava (3 cases); the heart (2 cases); the lung and chest wall (3 cases); and the trachea (1 case). Overall survival was significantly better among the patients submitted to complete surgical resection than among those submitted to incomplete resection. The frequency of incomplete resection was significantly higher in cases in which the tumor had invaded organs other than the lung (as identified through imaging studies) than in those in which it was restricted to the lung (47.6% vs. 14.3%; p = 0.04). None of the other preoperative characteristics analyzed were found to be associated with complete resection. |
4 |
| 44. Murata K, Takahashi M, Mori M, et al. Chest wall and mediastinal invasion by lung cancer: evaluation with multisection expiratory dynamic CT. Radiology. 191(1):251-5, 1994 Apr. |
Review/Other-Dx |
15 patients |
To assess the utility of multisection expiratory dynamic (ED) computed tomography (CT) in evaluation of tumor invasion in the chest wall or mediastinum. |
ED CT showed that the tumors in five patients were fixed to the chest wall (n = 2) or mediastinum (n = 3); free movement of tumor along the peripheral (n = 7) or mediastinal (n = 3) pleura was proved in the 10 other patients. At pathologic examination, the ED CT findings were proved correct in all patients. In six patients, ED CT provided additional information about tumor invasion that could not be obtained with conventional criteria. |
4 |
| 45. Seo JS, Kim YJ, Choi BW, Choe KO. Usefulness of magnetic resonance imaging for evaluation of cardiovascular invasion: evaluation of sliding motion between thoracic mass and adjacent structures on cine MR images. J Magn Reson Imaging. 22(2):234-41, 2005 Aug. |
Observational-Dx |
26 patients |
To determine the feasibility and usefulness of MRI for evaluating cardiovascular invasion of a thoracic mass by demonstrating the sliding motion between the mass and adjacent structures. |
The cine MR images showed the presence of sliding motion in 39 structures in 20 patients, which were surgically confirmed as not being invaded, and 15 structures in 6 patients with the absence of sliding motion noted as tumor invasion. The accuracy of the cine MRI was 94.4% (51/54) for evaluating cardiovascular invasion of a thoracic mass. MRI can provide additional information and improve the accuracy of preoperative staging for predicting cardiovascular invasion of a thoracic mass by evaluating the sliding motion. |
3 |
| 46. Shiotani S, Sugimura K, Sugihara M, et al. Diagnosis of chest wall invasion by lung cancer: useful criteria for exclusion of the possibility of chest wall invasion with MR imaging. Radiat Med. 18(5):283-90, 2000 Sep-Oct. |
Observational-Dx |
20 patients |
To compare the accuracy of thin-section CT, conventional static MR imaging (conventional MRI), and breathing dynamic echo planar magnetic resonance imaging (BDEPI) in evaluating lung cancer invasion to the chest wall. |
All patients were confirmed to have no chest wall invasion after surgery. By thin-section CT, 10 of 20 patients were correctly diagnosed as having no chest wall invasion (50% specificity). Two of the 20 patients were incorrectly diagnosed as having chest wall invasion by conventional MRI and BDEPI (90% specificity). |
2 |
| 47. Kajiwara N, Akata S, Uchida O, et al. Cine MRI enables better therapeutic planning than CT in cases of possible lung cancer chest wall invasion. Lung Cancer. 69(2):203-8, 2010 Aug. |
Observational-Dx |
100 patients |
To evaluate the hypothesis that lung cancer treatment planning (whether or not to use induction therapy) can be improved if respiratory dynamic cine magnetic resonance imaging (RD MR) is used. |
Concerning the evaluation of chest wall invasion, conventional computed tomography (CT) had 43.9% specificity, 60.0% sensitivity and 47.1% accuracy, while RD MR had 68.5% specificity, 100.0% sensitivity and 77.0% accuracy. RD MRI was particularly useful in the evaluation of cancers around 5 cm in diameter that were located adjacent to the diaphragm. Postoperative evaluation of superior sulcus tumor cases that had received induction therapy also showed that the RD MR procedure enabled an accurate decision in 87.5% of cases, and there were no false negative cases. |
2 |
| 48. Akata S, Kajiwara N, Park J, et al. Evaluation of chest wall invasion by lung cancer using respiratory dynamic MRI. J Med Imaging Radiat Oncol. 52(1):36-9, 2008 Feb. |
Observational-Dx |
61 patients |
To evaluate chest wall invasion by lung cancer using respiratory dynamic MRI. |
At pathological examination, the respiratory dynamic MRI findings were proved correct in all patients. Pathologically, 20 patients had chest wall invasion and their respiratory dynamic MRI was positive (sensitivity 100%). There were 7 false-positive results among the 41 patients without chest wall invasion (specificity 82.9%). Respiratory dynamic MRI may improve the accuracy of conventional CT scan or MRI in the prediction of chest wall invasion of lung cancer, especially in patients in whom the results of conventional CT scan or MRI appear equivocal in the presence of a peripheral mass abutting the chest wall surface without obvious chest wall invasion. |
3 |
| 49. Carter BW, Benveniste MF, Betancourt SL, et al. Imaging Evaluation of Malignant Chest Wall Neoplasms. [Review]. Radiographics. 36(5):1285-306, 2016 Sep-Oct. |
Review/Other-Dx |
N/A |
To discuss the evaluation of malignant chest wall neoplasms. |
No results stated in the abstract. |
4 |
| 50. Heelan RT, Demas BE, Caravelli JF, et al. Superior sulcus tumors: CT and MR imaging. Radiology. 170(3 Pt 1):637-41, 1989 Mar. |
Review/Other-Dx |
31 patients |
To discuss imaging recommendations of sulcus tumors using CT and MR imaging. |
No results stated in the abstract. |
4 |
| 51. Guimaraes MD, Hochhegger B, Santos MK, et al. Magnetic resonance imaging of the chest in the evaluation of cancer patients: state of the art. Radiol. Bras.. 48(1):33-42, 2015 Jan-Feb. |
Review/Other-Dx |
N/A |
To discuss the advantages of MRI in the evaluation of cancer patients. |
No results stated in the abstract. |
4 |
| 52. Hierholzer J, Luo L, Bittner RC, et al. MRI and CT in the differential diagnosis of pleural disease. Chest. 118(3):604-9, 2000 Sep. |
Observational-Dx |
42 patients |
To explore the role of MRI in the differential diagnosis of pleural disease. |
Mediastinal pleural involvement, circumferential pleural thickening, nodularity, irregularity of pleural contour, and infiltration of the chest wall and/or diaphragm were most suggestive of a malignant cause both on CT and MRI. Pleural calcification on CT was suggestive of a benign cause. Contrary to what has been previously reported in the literature, neither on CT nor on MRI, pleural thickness >1 cm revealed significant difference between malignant and benign pleural disease (p>0.05, chi(2) test). High signal intensity in relation to intercostal muscles on T2-weighted and/or contrast-enhanced T1-weighted images was significantly suggestive for a malignant disease. Using morphologic features in combination with the signal intensity features, MRI had a sensitivity of 100% and a specificity of 93% in the detection of pleural malignancy. |
2 |
| 53. Proli C, De Sousa P, Jordan S, et al. A diagnostic cohort study on the accuracy of 18-fluorodeoxyglucose (18FDG) positron emission tomography (PET)-CT for evaluation of malignancy in anterior mediastinal lesions: the DECiMaL study. BMJ Open. 8(2):e019471, 2018 02 06. |
Observational-Dx |
134 patients |
To determine the value by defining the diagnostic performance of fluorodeoxyglucose positron emission tomography (FDG PET)/CT for malignancy in patients undergoing surgery with an anterior mediastinal mass in order to ascertain the clinical utility of PET/CT to differentiate malignant from benign aetiologies in patients presenting with an anterior mediastinal mass SETTING. |
The sensitivity and specificity of PET/CT to correctly classify malignant disease were 83% (95% CI 74 to 89) and 58% (95% CI 37 to 78). The positive and negative predictive values were 90% (95% CI 83% to 95%) and 42% (95% CI 26% to 61%). |
2 |
| 54. Jerushalmi J, Frenkel A, Bar-Shalom R, Khoury J, Israel O. Physiologic thymic uptake of 18F-FDG in children and young adults: a PET/CT evaluation of incidence, patterns, and relationship to treatment. J Nucl Med. 50(6):849-53, 2009 Jun. |
Review/Other-Dx |
160 patients ( 559 consecutive studies) |
To define the incidence, patterns, and intensity of thymic (18)F-FDG uptake in relationship to age and time after treatment in a large cohort of patients. |
There were 137 of 559 T+ studies (25%), with equal sex distribution. T+ studies were found in significantly younger patients (20.6 +/- 9.3 y vs. 27.4 +/- 8.4 y, P < 0.001). Most T+ patients (60%) showed an inverted V pattern of thymic uptake, with additional unilateral mediastinal extension in 24% and focal midline uptake in 16% of studies. T+ studies were encountered in 80% of patients younger than 10 y, compared with 8% of patients in the 31- to 40-y age group. There were 17% T+ studies at baseline, 6% during treatment, 8% at the end of treatment, and 27%-40% during follow-up. The average SUVmax of thymic (18)F-FDG uptake was 3.73 +/- 1.22. |
4 |
| 55. Yabuuchi H, Matsuo Y, Abe K, et al. Anterior mediastinal solid tumours in adults: characterisation using dynamic contrast-enhanced MRI, diffusion-weighted MRI, and FDG-PET/CT. Clin Radiol. 70(11):1289-98, 2015 Nov. |
Observational-Dx |
48 patients |
To find significant parameters to characterise anterior mediastinal solid tumours in adults using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), diffusion-weighted MRI (DWI), and combined 2-[(18)F]-fluoro-2-deoxy-d-glucose positron-emission tomography/computed tomography (FDG-PET/CT). |
The washout pattern on TIC was seen only in thymic epithelial tumours (20/32). SUVmax of lymphoma (mean, 17.9), malignant germ cell tumours (14.2), and thymic carcinomas (15.6) were significantly higher than that of thymomas (6.1). The mean maximal diameter of thymic epithelial tumours was significantly smaller than that of lymphomas (p<0.01) and malignant germ cell tumours (p<0.05). The validation study also yielded high accuracy (38/42, 91%) in differentiation among the anterior mediastinal solid tumours. |
2 |
| 56. Kitami A, Sano F, Ohashi S, et al. The Usefulness of Positron-Emission Tomography Findings in the Management of Anterior Mediastinal Tumors. Annals of Thoracic & Cardiovascular Surgery. 23(1):26-30, 2017 Feb 20. |
Observational-Dx |
105 patients |
To evaluate the usefulness of positron-emission tomography/computed tomography (PET/CT) findings in the classification and management of anterior mediastinal tumors. |
The histological classifications were as follows: thymoma (n = 49), thymic carcinoma (TC) (n = 19), malignant lymphoma (ML) (n = 8), teratoma (n = 7), thymic cyst (n = 14), and others (n = 8). Upon visual inspection (SUV max: >2.0), all of the malignant tumors showed 18F-FDG accumulation (with the exception of one type A thymoma). Two of the 14 thymic cysts and three of the seven teratomas showed slight 18F-FDG accumulation. The SUV max values of the low-grade thymomas, high-grade thymomas, TCs and MLs were 3.14 ± 0.73, 4.34 ± 1.49, 8.59 ± 3.05, and 10.08 ± 2.53, respectively, with significant differences between the low- and high-grade thymomas, and between TCs and MLs. The sensitivity, specificity and accuracy of 18F-FDG in the detection of low-grade thymomas and thymomas with a maximum diameter of =50 mm and an SUV max of =3.4 were 85%, 48%, and 60%, respectively. |
3 |
| 57. Luzzi L, Campione A, Gorla A, et al. Role of fluorine-flurodeoxyglucose positron emission tomography/computed tomography in preoperative assessment of anterior mediastinal masses. European Journal of Cardio-Thoracic Surgery. 36(3):475-9, 2009 Sep. |
Observational-Dx |
19 patients |
To explore the usefulness of fluorine-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET-CT) in the preoperative assessment of isolated anterior mediastinal lesions, especially in the planning of operative strategy (biopsy or upfront resection). |
There were 13 thymomas (six LRT and seven HRT), three lymphomas and three other primitive thymic tumours (one paraganglioma, two non-seminomatous germ cell tumours). In LRT, the mean SUV was 3.3+/-0.5 resulting significantly lower than HRT, 13.5+/-7 (p=0.009). The SUV in LRT was also significantly lower with respect to lymphoma, 12.4+/-4 (p=0.001), and the other primitive anterior mediastinal tumours, 8+/-0.8 (p=0.001). Between thymomas we found a significant correlation between Masaoka stage and SUV, r=0.718, p=0.006. No correlation was found between transverse diameters and SUV, r=0.141, p=0.6. |
2 |
| 58. Pruente R, Restrepo CS, Ocazionez D, Suby-Long T, Vargas D. Fatty lesions in and around the heart: a pictorial review. British Journal of Radiology. 88(1051):20150157, 2015 Jul. |
Review/Other-Dx |
N/A |
To familiarize radiologists with these fat-containing lesions and to help avoid misdiagnosis and errors in management. This pictorial review will discuss the normal fatty structures in and around the heart. A range of common and uncommon fat-containing lesions will then be reviewed based upon lesion location. |
No results stated in the abstract. |
4 |
| 59. Totanarungroj K, Watcharaporn C, Muangman N. Helpful CT findings for giving specific diagnosis of anterior mediastinal tumors. Journal of the Medical Association of Thailand. 93(4):489-96, 2010 Apr. |
Review/Other-Dx |
50 chest CT studies |
To characterize the CT features of common anterior mediastinal tumors and evaluate CT findings that may help in suggesting specific diagnosis among these tumors. |
Fat density within the mass was present in 57.1% with germ cell tumor which was significantly higher than other anterior mediastinal tumors (p < 0.05). The presence of associated mediastinal lymphadenopathy was significantly found in lymphoma (75.0%) compared to other tumors (p < 0.05). The other CT findings showed no significant difference among these diseases (p > 0.05). |
4 |
| 60. Mitchell DG, Crovello M, Matteucci T, Petersen RO, Miettinen MM. Benign adrenocortical masses: diagnosis with chemical shift MR imaging. Radiology. 1992; 185(2):345-351. |
Observational-Dx |
31 patients; 45 adrenal masses |
To investigate the role of chemical shift MRI in differentiating benign and malignant adrenal masses in a mixed population. |
Both myelolipomas and 26/27 benign cortical masses showed a loss of SI on at least one chemical shift image. Opposed-phase images were slightly more sensitive than fat-suppressed images in depicting lipid within benign cortical masses. All masses had higher SI than that of the liver on standard T2-weighted MR images. Chemical shift MRI can demonstrate lipid within benign adrenocortical masses and thus increase specificity, potentially obviating biopsy and aggressive follow-up. |
4 |
| 61. Priola AM, Priola SM, Ciccone G, et al. Differentiation of rebound and lymphoid thymic hyperplasia from anterior mediastinal tumors with dual-echo chemical-shift MR imaging in adulthood: reliability of the chemical-shift ratio and signal intensity index. Radiology. 274(1):238-49, 2015 Jan. |
Observational-Dx |
92 patients |
To prospectively evaluate (a) effectiveness and limits of dual-echo chemical-shift magnetic resonance (MR) imaging for distinguishing hyperplastic thymus from anterior mediastinal tumors in adulthood by using chemical-shift ratio ( CSR chemical-shift ratio ) and signal intensity index ( SII signal intensity index ), with proposal of optimal threshold value for each, and (b) whether age affects these indexes. |
Interreader agreement was excellent (intraclass correlation coefficient: CSR chemical-shift ratio , 0.893; SII signal intensity index , 0.898). Mean CSR chemical-shift ratio and SII signal intensity index ± standard deviation were 0.545 ± 0.162 and 46.29% ± 18.41 for group A and 1.045 ± 0.094 and -0.06% ± 4.89 for group B, respectively, with significant differences for both indexes between groups (P < .0001). No overlap was found for SII signal intensity index between groups; CSR chemical-shift ratio values overlapped in a few younger adults. Distinguishing hyperplastic thymus from tumors was better with SII signal intensity index than CSR chemical-shift ratio . Respective sensitivity, specificity, and cutoff points were 100%, 100%, and 8.92% for SII signal intensity index and 100%, 96.7%, and 0.849 for CSR chemical-shift ratio . Significant correlation was found for CSR chemical-shift ratio (r = -0.761) and SII signal intensity index (r = 0.821) with age in group A (P < .001). For group B, significant correlation with age was seen for CSR chemical-shift ratio (r = 0.702, P < .001) but not SII signal intensity index (r = -0.196, P = .127). All subjects but one in group A and none in group B had signal intensity decrease at chemical-shift MR imaging. |
2 |
| 62. Douis H, Saifuddin A. The imaging of cartilaginous bone tumours. I. Benign lesions. [Review]. Skeletal Radiol. 41(10):1195-212, 2012 Sep. |
Review/Other-Dx |
N/A |
To discuss the imaging features of the cartilaginous bone tumors. |
No results stated in the abstract. |
4 |
| 63. Shiraj S, Kim HK, Anton C, Horn PS, Laor T. Spatial variation of T2 relaxation times of patellar cartilage and physeal patency: an in vivo study in children and young adults. AJR Am J Roentgenol. 202(3):W292-7, 2014 Mar. |
Observational-Dx |
52 patients |
To determine whether the T2 spatial variation of patellar cartilage is different between children and young adults with open and closed physes. |
All the subjects from 5 to 11 years old had open physes and all the subjects from 17 to 22 years old had closed physes. Mean T2 relaxation times of patellar cartilage in the open physis group were significantly longer than in the closed physis group throughout all normalized distances across patellar cartilage (p<0.05). There were significant differences in T2 spatial variation between the two groups (p<0.05). The open physis group had longer mean T2 relaxation times at the osteochondral area and articular cartilage than in the central portion. The closed physis group had shorter mean T2 relaxation times in the osteochondral area, with a gradual increase to longer values at the articular surface. Differences in T2 spatial variation were greatest at the osteochondral junction (p<0.05). There was no statistically significant sex difference in T2 spatial variation in either group. |
3 |
| 64. Hricak H, Tscholakoff D, Heinrichs L, et al. Uterine leiomyomas: correlation of MR, histopathologic findings, and symptoms. Radiology. 158(2):385-91, 1986 Feb. |
Review/Other-Dx |
57 patients |
To discuss the correlation of MR, histopathologic findings and symptoms of Uterine leiomyomas. |
Fifty-seven leiomyomas were identified in the corpus uterus, one was located within the broad ligament, and another was detected in the cervix. Among the corpus lesions, 9 were correctly identified on MR images as subserosal and 37 as intramural. Of 11 tumors assigned at surgery to the submucosal group, 10 had been accurately defined with MR. On MR, myomas associated with hypermenorrhea produced an anatomic disruption of the "junctional zone" (the low-intensity band seen at the myometrium-endometrium junction on T2 contrast images). Long TR (2 sec) and TE (56 msec) parameters (T2 contrast images) yielded the best contrast resolution between leiomyoma and surrounding myometrium. Correlation of MR with histologic features demonstrated 2 groups of lesions. Leiomyomas free of degenerative changes emitted homogeneous signals of low intensity. Contrast between tumor and myometrium was -16% on the T1 contrast image and increased to -44 +/- 16% on the T2 contrast image. Leiomyomas with hyaline, myxomatous, or fatty degeneration demonstrated various degrees of inhomogeneity, best seen on images obtained with long TR and TE. It is concluded that MR is an accurate modality for imaging uterine leiomyomas, since it clearly demonstrates tumor number, size, location, and the presence and extent of degeneration. |
4 |
| 65. Levesque MH, Aisagbonhi O, Digumarthy S, Wright CD, Ackman JB. Primary Paratracheal Leiomyoma: Increased Preoperative Diagnostic Specificity With Magnetic Resonance Imaging. Ann Thorac Surg. 102(2):e151-4, 2016 Aug. |
Review/Other-Dx |
1 patient |
To discuss how magnetic resonance imaging can substantially contribute to mediastinal mass characterization and diagnostic specificity. |
No results stated in the abstract. |
4 |
| 66. Garrana SH, Buckley JR, Rosado-de-Christenson ML, Martinez-Jimenez S, Munoz P, Borsa JJ. Multimodality Imaging of Focal and Diffuse Fibrosing Mediastinitis. [Review]. Radiographics. 39(3):651-667, 2019 May-Jun. |
Review/Other-Dx |
N/A |
To discuss the characteristic features of fibrosing mediastinitis. |
No results stated in the abstract. |
4 |
| 67. Chung JH, Cox CW, Forssen AV, Biederer J, Puderbach M, Lynch DA. The dark lymph node sign on magnetic resonance imaging: a novel finding in patients with sarcoidosis. J Thorac Imaging. 29(2):125-9, 2014 Mar. |
Review/Other-Dx |
51 patients |
To describe a characteristic magnetic resonance imaging (MRI) appearance of lymphadenopathy in sarcoidosis--the dark lymph node sign (DLNS)--and to determine its prevalence in a retrospective review of cardiopulmonary MRI examinations obtained in patients with sarcoidosis. |
Of the 51 patients with sarcoidosis, 49% (25 patients) demonstrated the DLNS. Nodal calcification was present on computed tomography in 45.7% (16/35) of patients with computed tomography scans obtained within 90 days of MRI. The DLNS sign was not more common in those with nodal calcification. When the DLNS occurred in conjunction with calcified nodes, the extent of hypointensity on MRI was not strictly limited to the calcified portions of the lymph node in 71.4% (5/7) of such cases. |
4 |
| 68. Khashper A, Addley HC, Abourokbah N, Nougaret S, Sala E, Reinhold C. T2-hypointense adnexal lesions: an imaging algorithm. Radiographics. 32(4):1047-64, 2012 Jul-Aug. |
Review/Other-Dx |
N/A |
To discuss a proposed diagnostic algorithm that takes these features into account, as well as the appearances of the lesion with additional pulse sequences, to aid in the correct interpretation of T2-hypointense adnexal lesions |
No results stated in the abstract. |
4 |
| 69. Madan R, Ratanaprasatporn L, Ratanaprasatporn L, Carter BW, Ackman JB. Cystic mediastinal masses and the role of MRI. [Review]. Clinical Imaging. 50:68-77, 2018 Jul - Aug. |
Review/Other-Dx |
N/A |
To describes how non-vascular MR provides greater diagnostic precision in the evaluation of indeterminate cystic mediastinal masses on CT |
No results stated in the abstract. |
4 |
| 70. Shin KE, Yi CA, Kim TS, et al. Diffusion-weighted MRI for distinguishing non-neoplastic cysts from solid masses in the mediastinum: problem-solving in mediastinal masses of indeterminate internal characteristics on CT. Eur Radiol. 24(3):677-84, 2014 Mar. |
Observational-Dx |
25 patients |
To evaluate the usefulness of diffusion-weighted (DW) magnetic resonance images for distinguishing non-neoplastic cysts from solid masses of indeterminate internal characteristics on computed tomography (CT) in the mediastinum. |
The enrolled patients had 15 solid masses and ten non-neoplastic cysts. Although the morphological features and the extent of enhancement on CT did not differ significantly between solid and cystic masses in the mediastinum (P?>?0.05), non-neoplastic cysts were distinguishable from solid masses by showing signal suppression on high-b-value DW images or high apparent diffusion coefficient (ADC) values of more than 2.5?×?10(-3) mm(2)/s (P?<?0.001). ADC values of non-neoplastic cysts (3.67?±?0.87?×?10(-3) mm(2)/s) were significantly higher than that of solid masses (1.46?±?0.50?×?10(-3) mm(2)/s) (P?<?0.001). |
2 |
| 71. Abdel Razek AA, Khairy M, Nada N. Diffusion-weighted MR imaging in thymic epithelial tumors: correlation with World Health Organization classification and clinical staging. Radiology. 273(1):268-75, 2014 Oct. |
Observational-Dx |
30 patients |
To assess thymic epithelial tumors with diffusion-weighted magnetic resonance (MR) imaging. |
There was significant difference in longest diameter (P = .001) and necrotic part of the tumor (P = .014) between low-risk thymoma, high-risk thymoma, and thymic carcinoma. Mean ADC value of both readings of thymic epithelial tumors (n = 30) was 1.24 × 10(-3) mm(2)/sec and 1.22 × 10(-3) mm(2)/sec, with good intraobserver agreement (? = 0.732). There was significant difference in both readings (P = .01 and .20) of low-risk thymoma (1.30 × 10(-3) mm(2)/sec and 1.29 × 10(-3) mm(2)/sec), high-risk thymoma (1.16 × 10(-3) mm(2)/sec and 1.14 × 10(-3) mm(2)/sec), and thymic carcinoma (1.18 × 10(-3) mm(2)/sec and 1.06 × 10(-3) mm(2)/sec). Cutoff ADC values of both readings used to differentiate low-risk thymoma from high-risk thymoma and thymic carcinoma were 1.25 and 1.22 × 10(-3) mm(2)/sec with area under the curve of 0.804 and 0.851, respectively. There was significant difference in both readings of ADC value of early (stage I, II) and advanced stages (stage III, IV) of thymic epithelial tumors (P = .006 and .005, respectively). |
2 |
| 72. Sakai S, Murayama S, Soeda H, Matsuo Y, Ono M, Masuda K. Differential diagnosis between thymoma and non-thymoma by dynamic MR imaging. Acta Radiol. 43(3):262-8, 2002 May. |
Review/Other-Dx |
59 patients |
To evaluate the usefulness of dynamic MR imaging for differential diagnosis of anterior mediastinal tumors. |
The mean peak time of the TIC was 1.5 min in thymoma and 3.2 min in non-thymoma cases. The difference was statistically significant. Stages I and II of thymoma showed a mean value of 1.3 min, which was significantly shorter than that of 2.5 min in stage III. Differentiation of thymoma/non-thymoma based on the peak time of dynamic MR imaging showed optimal sensitivity (79%) and specificity (84%) when defining thymomas as lesions having peak time appearing earlier than 2 min and non-thymomas later than 2.5 min, with an accuracy of 81%. |
4 |
| 73. Erasmus JJ, McAdams HP, Donnelly LF, Spritzer CE. MR imaging of mediastinal masses. [Review] [185 refs]. Magn Reson Imaging Clin N Am. 8(1):59-89, 2000 Feb. |
Review/Other-Dx |
N/A |
To discuss the MR imaging of mediastinal masses. |
No results stated in the abstract. |
4 |
| 74. Tanaka O, Kiryu T, Hirose Y, Iwata H, Hoshi H. Neurogenic tumors of the mediastinum and chest wall: MR imaging appearance. [Review] [5 refs]. Journal of Thoracic Imaging. 20(4):316-20, 2005 Nov. |
Review/Other-Dx |
N/A |
To discuss the diagnosis of neurogenic tumors by using the multiplanar capability and high contrast resolution of MR imaging. |
No results stated in the abstract. |
4 |
| 75. Nakazono T, White CS, Yamasaki F, et al. MRI findings of mediastinal neurogenic tumors. [Review]. AJR. American Journal of Roentgenology. 197(4):W643-52, 2011 Oct. |
Review/Other-Dx |
N/A |
To review the clinical, pathologic, and MRI findings of mediastinal neurogenic tumors according to the three tumor origins: the peripheral nerves, sympathetic ganglia, and paraganglia. |
No results stated in the abstract. |
4 |
| 76. Guan YB, Zhang WD, Zeng QS, Chen GQ, He JX. CT and MRI findings of thoracic ganglioneuroma. British Journal of Radiology. 85(1016):e365-72, 2012 Aug. |
Review/Other-Dx |
22 patient |
To improve diagnostic accuracy and facilitate differential diagnosis, we summarised the CT and MRI findings of thoracic ganglioneuroma. |
Of 22 lesions, 19 occurred in the posterior mediastinum, 2 in the lateral pleura and 1 in the right chest. The CT value of the plain scans ranged from 20 to 40 HU (mean 29.1 HU) in 16 cases. Punctate calcification was noted in four cases. Patchy fat density shadow was found in one case. Arterial-phase CT found nearly no enhancement (6 cases) or slight enhancement (10 cases) with a CT value of 0-12 HU (mean 5.8 HU). In the delayed phase, enhancement was strengthened progressively, and CT value of 10-20 HU (mean 13.6 HU) was achieved after 120 s. T(1) weighted images showed homogeneous hypointense signals in five cases and hypointense signals mixed with patchy hyperintense signal shadow in one case. T(2) weighted images demonstrated heterogeneous hyperintense signals in all six cases, of which the whorled appearance was noted in one case. Gadolinium-diethylenetriaminepentaacetic acid (Gd-DTPA)-enhanced MRI found mildly heterogeneous enhancement in the arterial phase, and progressive mild enhancement in the delayed phase. |
4 |
| 77. Ozawa Y, Kobayashi S, Hara M, Shibamoto Y. Morphological differences between schwannomas and ganglioneuromas in the mediastinum: utility of the craniocaudal length to major axis ratio. British Journal of Radiology. 87(1036):20130777, 2014 Apr. |
Review/Other-Dx |
36 schwannomas and ganglioneuromas |
To evaluate the diagnostic value of the craniocaudal length (CC) to major axis ratio (CC/M R) for differentiating between schwannoma and ganglioneuroma in the mediastinum on CT/MRI. |
The major axis, minor axis and CC measurements and CC/M R ranged from 23 to 52mm (mean, 37 mm), 15 to 38mm (28 mm), 25 to 62mm (42mm) and 0.66 to 1.4mm (1.1 mm), respectively, in Group A; from 18 to 97mm (37 mm), 10 to 71mm (28 mm), 18 to 80mm (35mm) and 0.59 to 1.3mm (0.95 mm), respectively, in Group B; and from 20 to 70mm (49 mm), 15 to 60mm (32 mm), 30 to 110mm (74mm) and 1.0 to 2.6mm (1.5 mm), respectively, in Group C. The mean CC/M R of Group C was significantly higher than those of the other two groups (p,0.005). There was no difference between the mean CC/M R of Groups A and B. |
4 |
| 78. Priola AM, Gned D, Marci V, Veltri A, Priola SM. Diffusion-weighted MRI in a case of nonsuppressing rebound thymic hyperplasia on chemical-shift MRI. Jpn J Radiol. 33(3):158-63, 2015 Mar. |
Review/Other-Dx |
1 patient |
To discuss a case of atypical RTH at CT with no signal suppression on chemical-shift MRI, arose after corticosteroid treatment for mixed cryoglobulinemia in a 60-year-old woman. |
No result stated in the abstract. |
4 |
| 79. 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. European Radiology. 28(4):1427-1437, 2018 Apr. |
Observational-Dx |
73 patients |
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. |
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. |
2 |
| 80. Kiryu S, Loring SH, Mori Y, Rofsky NM, Hatabu H, Takahashi M. Quantitative analysis of the velocity and synchronicity of diaphragmatic motion: dynamic MRI in different postures. Magn Reson Imaging. 24(10):1325-32, 2006 Dec. |
Observational-Dx |
8 healthy men |
To assess the relationship between right and left hemidiaphragmatic motions during breathing in normal subjects and to investigate alterations in lung motion with changes in posture, using dynamic magnetic resonance (MR) imaging. |
Excursion was greater in the right hemidiaphragm in most postures, except the left lateral decubitus. In supine and prone postures, both hemidiaphragms moved synchronously in both inspiratory and expiratory phases. In both lateral decubitus postures, the hemidiaphragms moved asynchronously with different velocities in the expiratory phase but with the same velocities in the inspiratory phase. |
3 |
| 81. KOLAR P, NEUWIRTH J, SANDA J, et al. Analysis of diaphragm movement during tidal breathing and during its activation while breath holding using MRI synchronized with spirometry. Physiol Res. 58(3):383-92, 2009. |
Review/Other-Dx |
16 patients |
To discuss the analysis of tidal movement using the magnetic resonance imaging (MRI) in conjunction with synchronized spirometry. |
No results stated in the abstract. |
4 |
| 82. Kolar P, Sulc J, Kyncl M, et al. Stabilizing function of the diaphragm: dynamic MRI and synchronized spirometric assessment. J Appl Physiol. 109(4):1064-71, 2010 Oct. |
Observational-Dx |
30 patients |
To describe diaphragmatic behavior during postural limb activities and examine the ventilatory and stabilizing functions of the diaphragm. |
Thirty healthy subjects were examined in the supine position using a dynamic MRI system assessed simultaneously with specialized spirometric readings. The diaphragmatic excursions (DEs) were measured at three diaphragmatic points in the sagittal plane; the diaphragm positions (DPs) as related to a reference horizontal baseline were determined. Measurements were taken during tidal breathing (TB) and isometric flexion of upper or lower extremities against external resistance together with TB. Mean DE in both upper and lower postural limb activities was greater compared with the TB condition (P < 0.05), with the effect greater for lower limb activities. Inspiratory DPs in the upper and lower extremity activities were lower compared with TB alone (P < 0.01). Expiratory DP was lower only for lower extremity activities (P < 0.01). DP was most affected at the apex of the crescent and crural (posterior) portion of the diaphragm. DEs correlated strongly with tidal volume (Vt) in all conditions. Changes in DEs relative to the initial value were minimal for upper and lower extremities but were related to lower values of Vt (P < 0.03). Significant involvement of the diaphragm in the limb postural activities was found. Resulting DEs and DPs differed from the TB conditions, especially in lower extremity activities. The differences between the percent changes of DEs vs. Vt found for lower extremity activities were confirmed by both ventilatory and postural diaphragm recruitment in response to postural demands. |
3 |
| 83. Gierada DS, Curtin JJ, Erickson SJ, Prost RW, Strandt JA, Goodman LR. Diaphragmatic motion: fast gradient-recalled-echo MR imaging in healthy subjects. Radiology. 194(3):879-84, 1995 Mar. |
Observational-Dx |
10 patients |
To investigate the feasibility of imaging diaphragmatic motion with a fast gradient-recalled-echo (GRE) magnetic resonance (MR) pulse sequence. |
Temporal and spatial resolutions were adequate in all subjects. Absolute excursion of the domes was 4.4 cm on the right and 4.2 cm on the left. Analysis of diaphragmatic displacement at different locations revealed a gradient of excursion that increased from anterior to middle to posterior (P < .05-.001; paired t test). Excursion of the lateral aspects was greater than that of the medial aspect (P < .001). |
2 |
| 84. Unal O, Arslan H, Uzun K, Ozbay B, Sakarya ME. Evaluation of diaphragmatic movement with MR fluoroscopy in chronic obstructive pulmonary disease. Clin Imaging. 24(6):347-50, 2000 Nov-Dec. |
Review/Other-Dx |
23 patients |
To show reduction of the diaphragmatic excursion with MR fluoroscopy in patients with chronic obstructive pulmonary disease (COPD) and to compare the results with pulmonary function test (PFT). |
No results stated in the abstract. |
4 |
| 85. Feragalli B, Mantini C, Patea RL, De Filippis F, Di Nicola E, Storto ML. Radiographic evaluation of mediastinal lines as a diagnostic approach to occult or subtle mediastinal abnormalities. Radiologia Medica. 116(4):532-47, 2011 Jun. |
Review/Other-Dx |
N/A |
To illustrate radiographic anatomy of the mediastinum with particular attention to mediastinal lines. |
No results stated in the abstract. |
4 |
| 86. Proto AV.. Mediastinal anatomy: emphasis on conventional images with anatomic and computed tomographic correlations. J Thorac Imaging. 2(1):1-48, 1987 Jan. |
Review/Other-Dx |
N/A |
To interpret mediastinal abnormalities, an understanding of the reflections produced by the various areas of lung in contact with the mediastinum is mandatory. |
No results stated in the abstract. |
4 |
| 87. Giron J, Fajadet P, Sans N, et al. Diagnostic approach to mediastinal masses. Eur J Radiol. 27(1):21-42, 1998 Mar. |
Review/Other-Dx |
N/A |
To discuss the diagnostic approach to mediastinal masses. |
No results stated in the abstract. |
4 |
| 88. Gibbs JM, Chandrasekhar CA, Ferguson EC, Oldham SA. Lines and stripes: where did they go?--From conventional radiography to CT. [Review] [14 refs]. Radiographics. 27(1):33-48, 2007 Jan-Feb. |
Review/Other-Dx |
N/A |
To evaluate the chest, although computed tomography (CT) and high-resolution CT are increasingly being used as an adjunct to conventional radiography for the evaluation of parenchymal and mediastinal disease. |
No results stated in the abstract. |
4 |
| 89. Wang D, Zhang J, Liu Y, et al. Diagnostic Value of Transthoracic Echocardiography Combined With Contrast-Enhanced Ultrasonography in Mediastinal Masses. Journal of Ultrasound in Medicine. 38(2):415-422, 2019 Feb. |
Review/Other-Dx |
48 patients |
To evaluate the diagnostic value of transthoracic echocardiography combined with contrast-enhanced ultrasonography in determining the location, composition, and vascularization of mediastinal masses. |
The localization, ultrasonographic characteristics of the mass, degree of vascularization, and relationships with the heart and great vessels assessed on echocardiography allowed a correct diagnosis in most of the cases. |
4 |
| 90. Zhou WW, Wang HW, Liu NN, et al. Diagnosis of malignancy of adult mediastinal tumors by conventional and transesophageal echocardiography. Chin Med J. 128(8):1047-51, 2015 Apr 20. |
Observational-Dx |
144 patients |
To compare the diagnostic impact of TEE and transthoracic echocardiography (TTE) for determining the localization, growth and malignancy of adult mediastinal tumors (MTs). |
All tumor lesions were diagnosed and carefully evaluated by biopsy. Biopsy revealed malignant tumors in 79 patients and benign tumors in 65 patients. When compared to histological findings, TEE predicted malignancy from the presence of tumors spreading both inside and outside of the heart and from infiltration and invasion in 49/79 patients (62.0%). TTE predicted malignancy in only 8/79 patients (10.1%, P < 0.005). TEE visualized tumor lesions in 130 patients (90.3%) while the TTE visualized tumor lesions in 110 patients (76.4%) and was less effective at detecting MT lesions (P < 0.001). TTE and TEE could detect anterior MTs and adequately verified MTs (P > 0.05); TEE detected medium MTs better than TTE (P < 0.001). |
1 |
| 91. Martelli M, Ceriani L, Zucca E, et al. [18F]fluorodeoxyglucose positron emission tomography predicts survival after chemoimmunotherapy for primary mediastinal large B-cell lymphoma: results of the International Extranodal Lymphoma Study Group IELSG-26 Study. J Clin Oncol. 32(17):1769-75, 2014 Jun 10. |
Observational-Dx |
125 patients |
To assess the role of [18F]fluorodeoxyglucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT) after rituximab and anthracycline-containing chemoimmunotherapy in patients with primary mediastinal large B-cell lymphoma (PMLBCL). |
Fifty-four patients (47%) achieved a complete metabolic response (CMR), defined as a completely negative scan or with residual [18F]FDG activity below the mediastinal blood pool (MBP) uptake. In the remaining 61 patients (53%), the residual uptake was higher than MBP uptake but below the liver uptake in 27 (23%), slightly higher than the liver uptake in 24 (21%), and markedly higher in 10 (9%). CMR after chemoimmunotherapy predicted higher 5-year progression-free survival (PFS; 98% v 82%; P=.0044) and overall survival (OS; 100% v 91%; P=.0298). Patients with residual uptake higher than MBP uptake but below liver uptake had equally good outcomes without any recurrence. Using the liver uptake as cutoff for PET positivity (boundary of score, 3 to 4) discriminated most effectively between high or low risk of failure, with 5-year PFS of 99% versus 68% (P<.001) and 5-year OS of 100% versus 83% (P<.001). |
2 |
| 92. Ceriani L, Martelli M, Zinzani PL, et al. Utility of baseline 18FDG-PET/CT functional parameters in defining prognosis of primary mediastinal (thymic) large B-cell lymphoma. Blood. 126(8):950-6, 2015 Aug 20.Blood. 126(8):950-6, 2015 Aug 20. |
Review/Other-Tx |
125 patients |
To evaluate the role of (18)F-fluorodeoxyglucose (18FDG) positron emission tomography/computed tomography (PET/CT) in the management of primary mediastinal (thymic) large B-cell lymphoma (PMBCL) |
Detailed clinical features and outcome of the patients enrolled in the IELSG 26 study have been published previously. Baseline PET/CT studies were available in 103 out of 125 patients, having been omitted in 20 patients because of the urgency of treatment and excluded in 2 cases (after central control) on technical grounds due to unacceptable lengthening of the uptake time. |
4 |
| 93. Nagle SJ, Chong EA, Chekol S, et al. The role of FDG-PET imaging as a prognostic marker of outcome in primary mediastinal B-cell lymphoma. Cancer Medicine. 4(1):7-15, 2015 Jan.Cancer Med. 4(1):7-15, 2015 Jan. |
Observational-Dx |
27 patients |
To evaluate outcomes of 27 primary mediastinal B-cell lymphoma(PMBL) patients treated with R-CHOP with or without radiation therapy (RT). It investigates the role of both interim and posttreatment. |
The present study evaluates outcomes of 27 PMBL patients treated with R-CHOP with or without radiation therapy (RT). It investigates the role of both interim and posttreatment fluorodeoxyglucose-positron emission tomography (FDG-PET) as prognostic markers of outcome. Additionally, it assesses postprogression therapies in the six patients who had progressive disease. At a median follow-up of 41.5 months (range: 6.1-147.2 months), OS was 95.5% (95% CI = 71.9-99.4) and progression-free survival (PFS) was 70.4% (95% CI = 49.4-83.9) for the entire cohort. The negative predictive values of interim and posttreatment FDG-PET scans were both 100%. Patients who failed initial therapy and were treated with salvage regimens and autologous stem cell transplantation (ASCT) all achieved and maintained CR. PMBL patients can achieve excellent outcomes with minimal toxicities when treated with R-CHOP with or without RT. Negative interim and negative posttreatment FDG-PET results identified PMBL patients who achieve long-term remission. However, the significance of both positive interim and positive posttreatment FDG-PET results needs to be better defined. Those who failed initial therapy were successfully treated with salvage regimens and ASCT. |
2 |
| 94. Filippi AR, Piva C, Levis M, et al. Prognostic Role of Pre-Radiation Therapy (18)F-Fluorodeoxyglucose Positron Emission Tomography for Primary Mediastinal B-Cell Lymphomas Treated with R-CHOP or R-CHOP-Like Chemotherapy Plus Radiation. International Journal of Radiation Oncology, Biology, Physics. 95(4):1239-43, 2016 07 15.Int J Radiat Oncol Biol Phys. 95(4):1239-43, 2016 07 15. |
Observational-Dx |
51 patients |
To validate, in a monoinstitutional cohort with extended follow-up, that post-rituximab chemotherapy (R-CT) (18)F-fluorodeoxyglucose positron emission tomography ((18)FDG-PET) is a prognostic factor allowing discrimination of primary mediastinal B-cell lymphoma (PMBCL) patients at higher risk for progression after radiation therapy. |
Median follow-up time was 51 months (range, 9-153 months). After R-CT, D5PS score was 1 in 10 (19.6%), 2 in 11 (21.6%), 3 in 7 (13.8%), 4 in 17 (33.3%), and 5 in 6 patients (11.7%). Forty-three out of 51 patients (84.3%) had an SUVmax =5, and 8 out of 51 (15.7%) had an SUVmax =5. Overall, 6 patients experienced progression or relapse: 1 had a D5PS score 2 (with SUVmax =5), and 5 had a D5PS score 5 (and SUVmax =5). Patients with a D5PS score 5 showed significantly lower PFS rates versus all other scores (log-rank P<.001), as did patients with SUVmax =5 when compared with those with SUVmax =5 (log-rank P<.001). |
1 |
| 95. Ceriani L, Milan L, Martelli M, et al. Metabolic heterogeneity on baseline 18FDG-PET/CT scan is a predictor of outcome in primary mediastinal B-cell lymphoma. Blood. 132(2):179-186, 2018 07 12. |
Observational-Dx |
103 patients |
To identify the patients for whom first-line therapy will fail to intervene before the lymphoma becomes refractory. High heterogeneity of intratumoral 18F-fluorodeoxyglucose (18FDG) uptake distribution on positron emission tomography/computed tomography (PET/CT) scans has been suggested as a possible marker of chemoresistance in solid tumors |
Metabolic heterogeneity (MH) was estimated using the area under curve of cumulative standardized uptake value-volume histogram (AUC-CSH) method. Progression-free survival at 5 years was 94% vs 73% in low- and high-MH groups, respectively (P = .0001). In a Cox model of progression-free survival including dichotomized MH, metabolic tumor volume, total lesion glycolysis (TLG), international prognostic index, and tumor bulk (mediastinal mass > 10 cm), as well as age as a continuous variable, only TLG (P < .001) and MH (P < .001) retained statistical significance. Using these 2 features to construct a simple prognostic model resulted in early and accurate (positive predictive value, 89%; negative predictive value, =90%) identification of patients at high risk for progression at a point that would allow the use of risk-adapted treatments. This may provide an important opportunity for the design of future trials aimed at helping the minority of patients who harbor chemorefractory PMBCL |
2 |
| 96. Lazarovici J, Terroir M, Arfi-Rouche J, et al. Poor predictive value of positive interim FDG-PET/CT in primary mediastinal large B-cell lymphoma. European Journal of Nuclear Medicine & Molecular Imaging. 44(12):2018-2024, 2017 Nov.Eur J Nucl Med Mol Imaging. 44(12):2018-2024, 2017 Nov. |
Review/Other-Dx |
36 patients |
To assess response to therapy, the prognostic value of interim FDG-PET/CT in Primary Mediastinal Large B-cell Lymphoma (PMBCL) is unclear. |
Interim FDG-PET/CT was considered positive in 17/36 patients using visual evaluation. Among these patients, 14 had a Deauville score of 4. Histological restaging was negative in all but one case, showing inflammation and/or fibrosis. After a median follow-up of 48.5 months, a total of five patients have relapsed, two patients in the positive FDG-PET/CT group, and three patients in the negative FDG-PET/CT group, respectively. |
4 |
| 97. Cheson BD. Staging and response assessment in lymphomas: the new Lugano classification. [Review]. Chinese Clinical Oncology. 4(1):5, 2015 Mar.Chin. clin. oncol.. 4(1):5, 2015 Mar. |
Review/Other-Dx |
80 patients |
To discuss the diagnostic impact of color Doppler sonographic features to support the differentiation of anterior mediastinal masses (AMMs). |
For this retrospective cohort study, a search of the database of the China Medical University Hospital using the clinical coding "ultrasound-guided biopsy" was conducted for the period December 2003 to February 2013. We selected patients diagnosed with AMMs (not cysts) using radiographic records. This search yielded a list of 80 cases. Real-time ultrasound-guided core needle biopsy (CNB) was performed in all but 5 patients without a sufficient safety range. In 89% (67/75) of these ultrasound-guided CNB cases, the diagnostic accuracy achieved subclassification. Fine-needle aspiration cytology achieved subclassification in only 10% of cases. On color Doppler sonography, 71% of lymphomas were characterized as "rich vascular with central/crisscross collocations" and 29% as "avascular or localized/scattered peripheral vessels." However, decreased proportions of "rich vascular with central/crisscross collocations" were found in lung cancer (4% [1/23], odds ratio = 0.018, 95% confidence interval: 0.002-0.154, p < 0.001) and thymoma/thymic carcinoma (25% [4/16]; odds ratio = 0.133, 95% confidence interval: 0.035-0.514, p = 0.003) compared with the lymphoma group. We conclude that the vessels in lymphoma AMMs have specific patterns on color Doppler sonography. Ultrasound-guided CNB of AMMs had an accuracy of = 89% in diagnosis and subclassification. Fine-needle aspiration cytology itself cannot aid in the diagnosis. Color Doppler sonographic evaluation of AMMs followed by real-time CNB is a more efficient method. |
4 |
| 98. Cheah CY, Hofman MS, Seymour JF, et al. The utility and limitations of (18)F-fluorodeoxyglucose positron emission tomography with computed tomography in patients with primary mediastinal B-cell lymphoma: single institution experience and literature review. Leukemia & Lymphoma. 56(1):49-56, 2015 Jan.Leuk Lymphoma. 56(1):49-56, 2015 Jan. |
Review/Other-Dx |
28 patients |
To discuss the role of 18F-fluorodeoxyglucose positron emission tomography with computed tomography (FDG PET-CT) scanning in primary mediastinal B-cell lymphoma (PMBL). |
We analyzed 28 patients with PMBL treated with chemotherapy, of whom 25 (89%) also received rituximab and 17 (61%) radiotherapy. PET-CT scans were interpreted using visual analysis and a 5-point scale. After a median follow-up of 2.6 years, four patients relapsed and two died. The 2-year progression-free survival and overall survival were 86% and 94%. PET-CT has excellent negative predictive value (interim, 86–87%; end of treatment, 95%) but limited positive predictive value due to the high frequency of positive scans. Several patients with persistent metabolically active masses underwent biopsies, which showed necrosis but no lymphoma. Thus a negative PET-CT is an excellent predictor of subsequent outcome. However, residual metabolically active masses after treatment should be biopsied to confirm viable lymphoma prior to salvage therapy. |
4 |
| 99. El-Bawab HY, Abouzied MM, Rafay MA, Hajjar WM, Saleh WM, Alkattan KM. Clinical use of combined positron emission tomography and computed tomography in thymoma recurrence. Interactive Cardiovascular & Thoracic Surgery. 11(4):395-9, 2010 Oct. |
Review/Other-Dx |
37 patients |
To evaluate the efficacy of hybrid fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) for surveillance and follow-up of thymoma patients to detect recurrent disease. |
A total of 51 CT-scans were performed on 37 patients providing sensitivity and specificity for thymoma recurrence of 71% and 85%, respectively. Forty-five FDG-PET/CT-scans were performed on the same group of patients with an overall sensitivity and specificity of 82% and 95%, respectively. Notably, FDG-PET/CT sensitivity when employed for diagnosis of thymoma recurrence in the anterior mediastinum has reached 100% (CT has shown only 55% sensitivity for the detection of anterior mediastinal thymoma recurrence). Our preliminary study demonstrates that during follow-up after thymoma excision, FDG-PET/CT is superior to computed tomography alone in the detection and localization of mediastinal recurrence. In particular, the combined structural and metabolic information of FDG-PET/CT enhances the diagnostic confidence in lesion characterization |
4 |
| 100. Kerpel A, Beytelman A, Ofek E, Marom EM. Magnetic Resonance Imaging for the Follow-up of Treated Thymic Epithelial Malignancies. J Thorac Imaging. 34(6):345-350, 2019 Nov. |
Review/Other-Dx |
187 patients |
To compare magnetic resonance imaging (MRI) depiction of thymic malignancy progression/recurrence with that of computed tomography (CT). |
Of 187 patients treated in our institution for TEM, 22 were followed-up with both CT and MRI. TNM stage at diagnosis was as follows: I (n=14), II (n=1), IIIa (n=4), IIIb (n=2), IVa (n=1), and IVb (n=0). Patients were followed-up for a mean of 6.2 years, range 0.7 to 17.7 years. The mean interval between CT and MRI was 5.4 (range, 1 to 15) months. Most patients had no recurrence (n=16), 4 had recurrence after R0 or R1 resection, 1 had stable disease, and 1 had progression of disease after R2 resection. CT and MRI performed equally in the identification of pleural spread (n=5), lymphadenopathy (n=4), and pulmonary metastases (n=1). Retrosternal recurrence (n=1) was identified by MRI despite sternotomy wire artifacts. MRI identified bone involvement and extension of disease into the thecal sac earlier and more readily. Three patients had an indeterminate mediastinal finding on CT that was correctly identified as a benign cyst or pericardial fluid collection by MRI. |
4 |
| 101. de Margerie-Mellon C, de Bazelaire C, Amorim S, et al. Diagnostic Yield and Safety of Computed Tomography-guided Mediastinal Core Needle Biopsies. Journal of Thoracic Imaging. 30(5):319-27, 2015 Sep. |
Review/Other-Dx |
285 patients |
To evaluate the diagnostic yield and complication rate of computed tomography (CT)-guided mediastinal core needle biopsies in a large population of patients presenting with mediastinal masses and to identify the factors that could influence these results. |
Malignant diagnoses, including lymphoproliferative disorders (N=151, 53%) and lung cancers (N=54, 19%), were established in 233 cases (82%). Benign lesions were found in 52 procedures (18%), including sarcoidosis (N=19, 7%) and infections (N=17, 6%). The overall diagnostic yield was 87% and was lower for lymphoma residual masses (57%) than for initial diagnosis or relapses of known disease (90%). Complications occurred in 21 patients (7%), but only 2 patients (0.7%) required hospitalization for >12 hours. Neither the diagnostic yield nor the complication rate was influenced by the target characteristics or by technical parameters. |
4 |
| 102. Petranovic M, Gilman MD, Muniappan A, et al. Diagnostic Yield of CT-Guided Percutaneous Transthoracic Needle Biopsy for Diagnosis of Anterior Mediastinal Masses. AJR. American Journal of Roentgenology. 205(4):774-9, 2015 Oct. |
Review/Other-Dx |
52 patients |
To evaluate the diagnostic yield and accuracy of CT-guided percutaneous biopsy of anterior mediastinal masses and assess prebiopsy characteristics that may help to select patients with the highest diagnostic yield. |
The study cohort included 52 patients (32 men, 20 women; mean age, 49 years) with mean diameter of mediastinal mass of 6.9 cm. Diagnostic yield of CT-guided percutaneous biopsy was 77% (40/52), highest for thymic neoplasms (100% [11/11]). Non-diagnostic results were seen in 12 of 52 patients (23%), primarily in patients with lymphoma (75% [9/12]). Fine-needle aspiration yielded the correct diagnosis in 31 of 52 patients (60%), and core biopsy had a diagnostic rate of 77% (36/47). None of the core biopsies were discordant with surgical pathology. There was no statistically significant difference between the diagnostic and the nondiagnostic groups in patient age, lesion size, and presence of necrosis. The complication rate was 3.8% (2/52), all small self-resolving pneumothoraces. |
4 |
| 103. Piplani S, Mannan R, Lalit M, Manjari M, Bhasin TS, Bawa J. Cytologic-radiologic correlation using transthoracic CT-guided FNA for lung and mediastinal masses: our experience. Anal Cell Pathol (Amst). 2014:343461, 2014. |
Review/Other-Dx |
74 patients |
To know the pathological spectrum of thoracic lesions and to correlate cytoradiological findings. |
The diagnostic accuracy for FNA in the present study was calculated to be 95.94% (using cytology as the gold standard). The predominant lesion was malignancy (85.1%), followed by suspicions of malignancy and inflammatory pathology (5.40% each). By cytology, the most common malignant lesion was adenocarcinoma (48%) followed by squamous cell carcinoma (40%), small cell carcinoma (8%), and undifferentiated carcinoma (4%). Cytoradiological correlation was found to be 89.2% in the present study. |
4 |
| 104. Yokoyama K, Ikeda O, Kawanaka K, et al. Comparison of CT-guided percutaneous biopsy with and without registration of prior PET/CT images to diagnose mediastinal tumors. Cardiovascular & Interventional Radiology. 37(5):1306-11, 2014 Oct. |
Observational-Dx |
106 patients |
To compare computed tomography (CT)-guided percutaneous biopsy with and without registration of prior positron emission tomography (PET)/CT images in the diagnosis of mediastinal tumors. |
CT-guided percutaneous needle biopsy yielded adequate samples in 101 of 106 (95 %) patients (group 1, n = 53; group 2, n = 48); in 95 patients (94 %), the diagnosis was confirmed by specific histological typing (group 1, n = 51; group 2, n = 44). The diagnostic accuracy of CT-guided percutaneous biopsy with and without the registration of prior PET/CT images was not statistically different (group 1, 96 %; group 2, 93 %, p = 0.324). |
2 |
| 105. Cao BS, Wu JH, Li XL, Deng J, Liao GQ. Sonographically guided transthoracic biopsy of peripheral lung and mediastinal lesions: role of contrast-enhanced sonography. Journal of Ultrasound in Medicine. 30(11):1479-90, 2011 Nov. |
Observational-Dx |
121 patients |
The purpose of this study was to assess the impact of contrast-enhanced sonography on sonographically guided transthoracic needle biopsy of lung lesions |
The enhancement intensity and extent varied greatly among different thoracic lesions, and an anechoic area (necrosis) was revealed in 26 of 62 lesions (41.9%) lesions after administration of the contrast agent. The overall diagnostic accuracy of sonographically guided transthoracic biopsy in this study was 85.9% (104 of 121). In the contrast-enhanced sonography group, the initial biopsy led to correct diagnosis in 58 of 62 lesions (93.6%). In the non-contrast-enhanced sonography group, the initial biopsy led to correct diagnosis in 46 of 59 lesions (78.0%). The difference in the diagnostic accuracy between the contrast-enhanced and non-contrast-enhanced sonography groups was statistically significant (P < .05). |
1 |
| 106. Chen HJ, Liao WC, Liang SJ, Li CH, Tu CY, Hsu WH. Diagnostic impact of color Doppler ultrasound-guided core biopsy on fine-needle aspiration of anterior mediastinal masses. Ultrasound in Medicine & Biology. 40(12):2768-76, 2014 Dec. |
Review/Other-Dx |
80 patients |
To discuss the impact of color Doppler sonographic features to support the differentiation of anterior mediastinal masses (AMMs). |
We selected patients diagnosed with AMMs (not cysts) using radiographic records. This search yielded a list of 80 cases. Real-time ultrasound-guided core needle biopsy (CNB) was performed in all but 5 patients without a sufficient safety range. In 89% (67/75) of these ultrasound-guided CNB cases, the diagnostic accuracy achieved subclassification. Fine-needle aspiration cytology achieved subclassification in only 10% of cases. On color Doppler sonography, 71% of lymphomas were characterized as “rich vascular with central/crisscross collocations” and 29% as “avascular or localized/scattered peripheral vessels.” However, decreased proportions of “rich vascular with central/crisscross collocations” were found in lung cancer (4% [1/23], odds ratio = 0.018, 95% confidence interval: 0.002–0.154, p < 0.001) and thymoma/thymic carcinoma (25% [4/16]; odds ratio = 0.133, 95% confidence interval: 0.035–0.514, p = 0.003) compared with the lymphoma group. We conclude that the vessels in lymphoma AMMs have specific patterns on color Doppler sonography. Ultrasound-guided CNB of AMMs had an accuracy of =89% in diagnosis and subclassification. Fine-needle aspiration cytology itself cannot aid in the diagnosis. Color Doppler sonographic evaluation of AMMs followed by real-time CNB is a more efficient method. |
4 |
| 107. Koegelenberg CF, Bolliger CT, Irusen EM, et al. The diagnostic yield and safety of ultrasound-assisted transthoracic fine-needle aspiration of drowned lung. Respiration. 81(1):26-31, 2011. |
Observational-Dx |
31 patients |
To explore the feasibility of US-assisted FNA in this setting by prospectively investigating its diagnostic yield and safety. |
Superficial FNA was diagnostic in 11 patients (35.5%), whereas deeper FNA was diagnostic in 23 patients (74.2%, p = 0.002). Deeper FNA confirmed malignancy in all cases with diagnostic superficial FNA. We observed no pneumothoraces or major hemorrhage. All patients were ultimately diagnosed with malignancy (bronchogenic carcinoma, n = 30; lymphoma, n = 1). |
2 |
| 108. Zhou JH, Shan HB, Ou W, et al. Contrast-Enhanced Ultrasound Improves the Pathological Outcomes of US-Guided Core Needle Biopsy That Targets the Viable Area of Anterior Mediastinal Masses. BioMed Research International. 2018:9825709, 2018. |
Observational-Dx |
92 patients |
To elucidate the correlation between the prebiopsy CEUS and diagnostic yield of AMMs and found that CEUS potentially improved the diagnostic yield of AMMs compared with conventional US with a significant increase in the cellularity of samples. |
No results stated in the abstract. |
2 |
| 109. Wahidi MM, Herth F, Yasufuku K, et al. Technical Aspects of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration: CHEST Guideline and Expert Panel Report. [Review]. Chest. 149(3):816-35, 2016 Mar. |
Review/Other-Dx |
7 evidence-based and 5 ungraded consensus-based statements |
To examine the current literature on the technical aspects of EBUS-TBNA as they relate to patient, technology, and proceduralist factors to provide evidence-based and expert guidance to clinicians. |
Our systematic review and critical analysis of the literature on 15 PICO questions related to the technical aspects of EBUS-TBNA resulted in 12 statements: 7 evidence-based graded recommendations and 5 ungraded consensus-based statements. Three questions did not have sufficient evidence to generate a statement. |
4 |
| 110. Guimaraes MD, Hochhegger B, Benveniste MF, et al. Improving CT-guided transthoracic biopsy of mediastinal lesions by diffusion-weighted magnetic resonance imaging. Clinics (Sao Paulo, Brazil). 69(11):787-91, 2014 Nov. |
Review/Other-Dx |
8 patients |
To evaluate the preliminary results obtained using diffusion-weighted magnetic resonance imaging and the apparent diffusion coefficient for planning computed tomography-guided biopsies of selected mediastinal lesions. |
In all cases, the biopsy needle was successfully directed to areas of higher signal intensity on diffusion-weighted sequences and the lowest apparent diffusion coefficient within the lesion (mean, 0.8 [range, 0.6-1.1]×10-3 mm2/s), suggesting high cellularity. All biopsies provided adequate material for specific histopathological diagnoses of four lymphomas, two sarcomas and two thymomas. |
4 |
| 111. Garnon J, Ramamurthy N, Caudrelier J J, et al. MRI-Guided Percutaneous Biopsy of Mediastinal Masses Using a Large Bore Magnet: Technical Feasibility. Cardiovascular & Interventional Radiology. 39(5):761-767, 2016 May. |
Observational-Dx |
16 patients |
To evaluate the diagnostic accuracy and safety of magnetic resonance imaging (MRI)-guided percutaneous biopsy of mediastinal masses performed using a wide-bore high-field scanner. |
Target lesions were located in the anterior (n = 13), middle (n = 2), and posterior mediastinum (n = 1), respectively. Mean size was 7.2 cm (range 3.6-11 cm). Average time for needle placement was 9.4 min (range 3-18 min); average duration of entire procedure was 42 min (range 27-62 min). 2-5 core samples were obtained from each lesion (mean 2.6). Technical success rate was 100%, with specimens successfully obtained in all 16 patients. There were no immediate complications. Histopathology revealed malignancy in 12 cases (4 of which were surgically confirmed), benign lesions in 3 cases (1 of which was false negative following surgical resection), and one inconclusive specimen (treated as inaccurate since repeat CT-guided biopsy demonstrated thymic hyperplasia). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in our study were 92.3, 100, 100, 66.7, and 87.5%, respectively. |
3 |
| 112. American College of Radiology. ACR Appropriateness Criteria® Radiation Dose Assessment Introduction. Available at: https://www.acr.org/-/media/ACR/Files/Appropriateness-Criteria/RadiationDoseAssessmentIntro.pdf. |
Review/Other-Dx |
N/A |
To provide evidence-based guidelines on exposure of patients to ionizing radiation. |
No abstract available. |
4 |
