Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Quantitative Thoracic Magnetic Resonance Criteria for the Differentiation of Cysts from Solid Masses in the Anterior Mediastinum

  • Eui Jin Hwang (Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • MunYoung Paek (Siemens Healthineers) ;
  • Soon Ho Yoon (Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Jihang Kim (Department of Radiology, Seoul National University Bundang Hospital) ;
  • Ho Yun Lee (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Jin Mo Goo (Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Hyungjin Kim (Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Heekyung Kim (Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Jeanne B. Ackman (Department of Radiology, Massachusetts General Hospital, Harvard Medical School)
  • Received : 2018.10.08
  • Accepted : 2019.01.12
  • Published : 2019.05.01
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Abstract

Objective: To evaluate quantitative magnetic resonance imaging (MRI) parameters for differentiation of cysts from and solid masses in the anterior mediastinum. Materials and Methods: The development dataset included 18 patients from two institutions with pathologically-proven cysts (n = 6) and solid masses (n = 12) in the anterior mediastinum. We measured the maximum diameter, normalized T1 and T2 signal intensity (nT1 and nT2), normalized apparent diffusion coefficient (nADC), and relative enhancement ratio (RER) of each lesion. RERs were obtained by non-rigid registration and subtraction of precontrast and postcontrast T1-weighted images. Differentiation criteria between cysts and solid masses were identified based on receiver operating characteristics analysis. For validation, two separate datasets were utilized: 15 patients with 8 cysts and 7 solid masses from another institution (validation dataset 1); and 11 patients with clinically diagnosed cysts stable for more than two years (validation dataset 2). Sensitivity and specificity were calculated from the validation datasets. Results: nT2, nADC, and RER significantly differed between cysts and solid masses (p = 0.032, 0.013, and < 0.001, respectively). The following criteria differentiated cysts from solid masses: RER < 26.1%; nADC > 0.63; nT2 > 0.39. In validation dataset 1, the sensitivity of the RER, nADC, and nT2 criteria was 87.5%, 100%, and 75.0%, and the specificity was 100%, 40.0%, and 57.4%, respectively. In validation dataset 2, the sensitivity of the RER, nADC, and nT2 criteria was 90.9%, 90.9%, and 72.7%, respectively. Conclusion: Quantitative MRI criteria using nT2, nADC, and particularly RER can assist differentiation of cysts from solid masses in the anterior mediastinum.

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References

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