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The Usefulness of Positron-Emission Tomography Findings in the Management of Anterior Mediastinal Tumors.

Research paper by Akihiko A Kitami, Fumitoshi F Sano, Shinichi S Ohashi, Kosuke K Suzuki, Shugo S Uematsu, Takashi T Suzuki, Mitsutaka M Kadokura

Indexed on: 27 Jan '17Published on: 27 Jan '17Published in: Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia



Abstract

We performed a retrospective analysis to evaluate the usefulness of positron-emission tomography/computed tomography (PET/CT) findings in the classification and management of anterior mediastinal tumors.Between 2006 and 2015, 105 patients with anterior mediastinal tumor received PET/CT. (18)F-fluorodeoxyglucose ((18)F-FDG)-PET images were obtained 60 minutes after the injection of (18)F-FDG.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 (18)F-FDG accumulation (with the exception of one type A thymoma). Two of the 14 thymic cysts and three of the seven teratomas showed slight (18)F-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 (18)F-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.FDG-PET/CT is an objective and useful modality in the differential diagnosis and management of anterior mediastinal tumors.

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