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

Surg Today. 2019 Feb;49(2):143-149. doi: 10.1007/s00595-018-1712-1. Epub 2018 Sep 10.

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.

Keywords: Anterior mediastinal mass; Malignant lymphoma; PET/CT; Thymoma.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Diagnosis, Differential
  • Female
  • Humans
  • Lymphoma / diagnostic imaging
  • Male
  • Mediastinal Neoplasms / diagnostic imaging*
  • Mediastinum / diagnostic imaging*
  • Middle Aged
  • Neoplasms, Germ Cell and Embryonal / diagnostic imaging
  • Positron Emission Tomography Computed Tomography*
  • Sensitivity and Specificity
  • Teratoma / diagnostic imaging
  • Thymoma / diagnostic imaging
  • Young Adult