Purpose: To evaluate the role of CT and PET/CT in thymic cancer and thymoma patients at initial staging. Methods and Materials: We retrospectively reviewed CT and PET/CT of 26 patients with a proven-diagnosis of thymic cancer (n=9)and thymoma (n=17).Chest CT findings documented were qualitative (calcification, peritumoral fat infiltration,pleural-pericardial effusion, degree of abutment of vessel circumference, et al)and quantitative (maximum axial and longitudinal diameter and volume).Both qualitative and semiquantitative data (standardised uptake value, total lesion glicolysis-TLG, metabolic tumor volume-MTV)were recovered by PET/CT.The outcome of all patients was retrieved by clinical chart or observational follow-up.The comparisons among histological entities, outcome and CT and PET/CT findings were evaluated using a non-parametric analysis. Results: PET/CT resulted positive in 15 patients with thymoma.100%of patients with thymic cancer had a positive scan.CT was available in 5/9 patients with thymic cancer and in 3/17 subjects with thymoma.All quantitative CT parameters were significantly higher in patients with thymic cancer than thymoma (MAD:45vs.20 mm,MLD:69vs.21 mm and volume:77.91vs.4.52 ml;all p < 0.05).Conversely, only MTV and TLG were significantly different in patients with thymic cancer than the counterpart (126.53vs.6.03 cm3 and 246.05vs.20.32,respectively;both p < 0.05).After a median follow-up of 17.45 months, four recurrences of disease occurred (three in patients with thymic cancer and one with a type B2 thymoma).Follow-up data were lost in three subjects.CT volume in a patient with recurrent disease was 170.12 ml vs. a median value of 10.5 ml in seven disease-free patients.MTV was higher in recurrent than disease-free subset (143.3vs.81.13 cm3),although not statistically significant (p=0.075). Conclusion: Both morphological and metabolic volume can be useful for diagnostic and prognostic meaning in thymic cancer and thymoma patients.
Conflicting or complementary role of computed tomography (CT) and positron emission tomography (PET)/CT in the assessment of thymic cancer and thymoma
SCAGLIORI, ELENA;PANUNZIO, ANNALORI GABRIELLA;NANNINI, NAZARENA;CALABRESE, FIORELLA;POMERRI, FABIO;
2014
Abstract
Purpose: To evaluate the role of CT and PET/CT in thymic cancer and thymoma patients at initial staging. Methods and Materials: We retrospectively reviewed CT and PET/CT of 26 patients with a proven-diagnosis of thymic cancer (n=9)and thymoma (n=17).Chest CT findings documented were qualitative (calcification, peritumoral fat infiltration,pleural-pericardial effusion, degree of abutment of vessel circumference, et al)and quantitative (maximum axial and longitudinal diameter and volume).Both qualitative and semiquantitative data (standardised uptake value, total lesion glicolysis-TLG, metabolic tumor volume-MTV)were recovered by PET/CT.The outcome of all patients was retrieved by clinical chart or observational follow-up.The comparisons among histological entities, outcome and CT and PET/CT findings were evaluated using a non-parametric analysis. Results: PET/CT resulted positive in 15 patients with thymoma.100%of patients with thymic cancer had a positive scan.CT was available in 5/9 patients with thymic cancer and in 3/17 subjects with thymoma.All quantitative CT parameters were significantly higher in patients with thymic cancer than thymoma (MAD:45vs.20 mm,MLD:69vs.21 mm and volume:77.91vs.4.52 ml;all p < 0.05).Conversely, only MTV and TLG were significantly different in patients with thymic cancer than the counterpart (126.53vs.6.03 cm3 and 246.05vs.20.32,respectively;both p < 0.05).After a median follow-up of 17.45 months, four recurrences of disease occurred (three in patients with thymic cancer and one with a type B2 thymoma).Follow-up data were lost in three subjects.CT volume in a patient with recurrent disease was 170.12 ml vs. a median value of 10.5 ml in seven disease-free patients.MTV was higher in recurrent than disease-free subset (143.3vs.81.13 cm3),although not statistically significant (p=0.075). Conclusion: Both morphological and metabolic volume can be useful for diagnostic and prognostic meaning in thymic cancer and thymoma patients.
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