Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Surgery Today
Published in: Surgery Today 2/2019

01-02-2019 | Original Article

Positron emission tomography/computed tomography as a clinical diagnostic tool for anterior mediastinal tumors

Authors: Tatsuaki Watanabe, Hideo Shimomura, Tatsushi Mutoh, Ryoko Saito, Ryoi Goto, Takehiro Yamada, Hirotsugu Notsuda, Yasushi Matsuda, Masafumi Noda, Akira Sakurada, Yasuyuki Taki, Yoshinori Okada

Published in: Surgery Today | Issue 2/2019

Login to get access

Abstract

Purpose

The purpose of this study was to assess the usefulness of positron emission tomography/computed tomography (PET/CT) in the differential diagnosis of anterior mediastinal tumors.

Methods

A total of 94 patients with anterior mediastinal masses or nodules (male, n = 41; female, n = 53; age, 17–84 years) were retrospectively evaluated. All patients were evaluated by PET/CT and the masses or nodules were histologically diagnosed in our institution.

Results

Anterior mediastinal masses and nodules were classified into two disease categories: Low (thymic hyperplasia, thymoma, mature teratoma, and MALT lymphoma) and High (thymic carcinoid, thymic cancer, diffuse large B-cell lymphoma, T-cell lymphoblastic lymphoma, Hodgkin’s lymphoma, and malignant germ cell tumors) groups. The sensitivity and specificity of maximum standardized uptake value (SUVmax) 7.5 for the detection of High group were 77% and 100%, respectively. The SUVmax distributions of the WHO histological thymoma types and Masaoka stage thymomas extensively overlapped. Masaoka stage III thymomas had significantly higher SUVmax than Masaoka stage I thymomas. Regarding the TNM classification, the SUVmax of T3 and T1b thymomas was higher than T1a thymoma.

Conclusion

Although the SUVmax of each disease overlapped, PET/CT findings provided useful information for the differential diagnosis of anterior mediastinal masses.
Literature
1.
Davis RD, Oldham HN, Sabiston DC. Primary cysts and neoplasms of the mediastinum: recent changes in clinical presentation, methods of diagnosis, management, and results. Ann Thorac Surg. 1987;44:229–37.CrossRef
2.
Detterbeck FC, Parsons AM. Thymic tumors. Ann Thorac Surg. 2004;77:1860–9.CrossRef
3.
Girard N, Mornex F, Van Houtte P, Cordier JF, van Schil P. Thymoma: a focus on current therapeutic management. J Thorac Oncol. 2009;4:119–26.CrossRef
4.
Carter BW, Marom EM, Detterbeck FC. Approaching the patient with an anterior mediastinal mass: a guide for clinicians. J Thorac Oncol. 2014;9:102–9.CrossRef
5.
Kubota K, Yamada S, Kondo T, Yamada K, Fukuda H, Fujiwara T, et al. PET imaging of primary mediastinal tumours. Br J Cancer. 1996;73:882–6.CrossRef
6.
Liu Y. Characterization of thymic lesions with F-18 FDG PET-CT: an emphasis on epithelial tumors. Nucl Med Commun. 2011;32:554–62.CrossRef
7.
Luzzi L, Campione A, Gorla A, Vassallo G, Bianchi A, Biggi A, et al. Role of fluorine-flurodeoxyglucose positron emission tomography/computed tomography in preoperative assessment of anterior mediastinal masses. Eur J Cardiothorac Surg. 2009;36:475–9.CrossRef
8.
Kitami A, Sano F, Ohashi S, Suzuki K, Uematsu S, Suzuki T, et al. The usefulness of positron-emission tomography findings in the management of anterior mediastinal tumors. Ann Thorac Cardiovasc Surg. 2017;23:26–30.CrossRef
9.
Endo M, Nakagawa K, Ohde Y, Okumura T, Kondo H, Igawa S, et al. Utility of 18FDG-PET for differentiating the grade of malignancy in thymic epithelial tumors. Lung Cancer. 2008;61:350–5.CrossRef
10.
Terzi A, Bertolaccini L, Rizzardi G, Luzzi L, Bianchi A, Campione A, et al. Usefulness of 18-F FDG PET/CT in the pre-treatment evaluation of thymic epithelial neoplasms. Lung Cancer. 2011;74:239–43.CrossRef
11.
Carter BW, Tomiyama N, Bhora FY, Rosado de Christenson ML, Nakajima J, Boiselle PM, et al. A modern definition of mediastinal compartments. J Thorac Oncol. 2014;9:97–101.CrossRef
12.
Masaoka A, Monden Y, Nakahara K, Tanioka T. Follow-up study of thymomas with special reference to their clinical stages. Cancer. 1981;48:2485–92.CrossRef
13.
Detterbeck FC, Stratton K, Giroux D, Asamura H, Crowley J, Falkson C, et al. The IASLC/ITMIG thymic epithelial tumors staging project: proposal for an evidence-based stage classification system for the forthcoming (8th) edition of the TNM classification of malignant tumors. J Thorac Oncol. 2014;9:65–72.CrossRef
14.
Sung YM, Lee KS, Kim BT, Choi JY, Shim YM, Yi CA. 18F-FDG PET/CT of thymic epithelial tumors: usefulness for distinguishing and staging tumor subgroups. J Nucl Med. 2006;47:1628–34.PubMed
15.
Otsuka H. The utility of FDG-PET in the diagnosis of thymic epithelial tumors. J Med Invest. 2012;59:225–34.CrossRef
16.
Sasaki M, Kuwabara Y, Ichiya Y, Akashi Y, Yoshida T, Nakagawa M, et al. Differential diagnosis of thymic tumors using a combination of 11C-methionine PET and FDG PET. J Nucl Med. 1999;40:1595–601.PubMed
17.
Liu RS, Yeh SH, Huang MH, Wang LS, Chu LS, Chang CP, et al. Use of fluorine-18 fluorodeoxyglucose positron emission tomography in the detection of thymoma: a preliminary report. Eur J Nucl Med. 1995;22:1402–7.CrossRef
18.
Matsumoto I, Oda M, Takizawa M, Waseda R, Nakajima K, Kawano M, et al. Usefulness of fluorine-18 fluorodeoxyglucose-positron emission tomography in management strategy for thymic epithelial tumors. Ann Thorac Surg. 2013;95:305–10.CrossRef
19.
Lococo F, Cesario A, Okami J, Cardillo G, Cavuto S, Tokunaga T, et al. Role of combined 18F-FDG-PET/CT for predicting the WHO malignancy grade of thymic epithelial tumors: a multicenter analysis. Lung Cancer. 2013;82:245–51.CrossRef
20.
Shibata H, Nomori H, Uno K, Sakaguchi K, Nakashima R, Iyama K, et al. 18F-fluorodeoxyglucose and 11C-acetate positron emission tomography are useful modalities for diagnosing the histologic type of thymoma. Cancer. 2009;115:2531–8.CrossRef
21.
Toba H, Kondo K, Sadohara Y, Otsuka H, Morimoto M, Kajiura K, et al. 18F-fluorodeoxyglucose positron emission tomography/computed tomography and the relationship between fluorodeoxyglucose uptake and the expression of hypoxia-inducible factor-1alpha, glucose transporter-1 and vascular endothelial growth factor in thymic epithelial tumours. Eur J Cardiothorac Surg. 2013;44:e105-12.PubMed
22.
Kumar A, Regmi SK, Dutta R, Kumar R, Gupta SD, Das P, et al. Characterization of thymic masses using (18)F-FDG PET-CT. Ann Nucl Med. 2009;23:569–77.CrossRef
23.
Fukumoto K, Taniguchi T, Ishikawa Y, Kawaguchi K, Fukui T, Kato K, et al. The utility of [18F]-fluorodeoxyglucose positron emission tomography-computed tomography in thymic epithelial tumours. Eur J Cardiothorac Surg. 2012;42:e152-6.CrossRef
24.
Viti A, Bertolaccini L, Cavallo A, Fortunato M, Bianchi A, Terzi A. 18-Fluorine fluorodeoxyglucose positron emission tomography in the pretreatment evaluation of thymic epithelial neoplasms: a metabolic biopsy confirmed by Ki-67 expression. Eur J Cardiothorac Surg 2014;46:369–74; (discussion 74).CrossRef
25.
Peterson L, Kurland B, Shields A, Novakova A, Christopfel R, Byrd D, et al. Reproducibility of FDG SUVmax for metastatic breast cancer lesions in the same or different PET/CT scanners in a local network. J Nucl Med. 2014;55:1.CrossRef
Metadata
Title
Positron emission tomography/computed tomography as a clinical diagnostic tool for anterior mediastinal tumors
Authors
Tatsuaki Watanabe
Hideo Shimomura
Tatsushi Mutoh
Ryoko Saito
Ryoi Goto
Takehiro Yamada
Hirotsugu Notsuda
Yasushi Matsuda
Masafumi Noda
Akira Sakurada
Yasuyuki Taki
Yoshinori Okada
Publication date
01-02-2019
Publisher
Springer Singapore
Published in
Surgery Today / Issue 2/2019
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-018-1712-1

Other articles of this Issue 2/2019

Surgery Today 2/2019 Go to the issue

Original Article

Perioperative factors associated with aneurysm sac size changes after endovascular aneurysm repair

Original Article

BRF2 as a promising indicator for radical lymph-node dissection surgery in patients with cN0 squamous cell carcinoma of the middle thoracic esophagus

Original Article

Adverse oncological outcome of surgical site infection after liver resection for colorectal liver metastases

Original Article

Risk factors and measures of pulmonary complications after thoracoscopic esophagectomy for esophageal cancer

Original Article

Three-port totally endoscopic repair vs conventional median sternotomy for atrial septal defect

Original Article

Surgical outcomes of modified-maze procedures in adults with atrial septal defect