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Published on: June 7, 2018
Histogram analysis based on unenhanced CT for identifying thymoma and lymphoma among prevascular mediastinal
Ming Liu1, Yang Zhang2,3, Li-Heng Liu4,5
1Department of Radiation Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
Insights
Histogram analysis of unenhanced CT scans can aid in differentiating thymic tumors like thymoma and lymphoma from non-tumorous conditions such as hyperplasia and cysts. This technique shows promise for diagnosing incidental prevascular mediastinal lesions.
Area of Science:
- Radiology
- Medical Imaging
- Oncology
Background:
- Incidental prevascular mediastinal lesions require accurate differential diagnosis.
- Distinguishing thymoma and lymphoma from thymic hyperplasia and cysts can be challenging.
- Unenhanced CT (computed tomography) is a common imaging modality.
Purpose of the Study:
- To evaluate the utility of histogram analysis on unenhanced CT for differentiating thymoma and lymphoma from thymic hyperplasia and cysts.
- To assess the diagnostic performance of histogram parameters in classifying these lesions.
Main Methods:
- Retrospective analysis of 192 asymptomatic patients with incidentally detected prevascular mediastinal lesions.
- Calculation of thirteen histogram parameters from unenhanced CT images.
- Comparison of histogram parameters between tumor (thymoma/lymphoma) and non-tumor (hyperplasia/cyst) groups.
- Receiver operating characteristic (ROC) analysis to determine diagnostic accuracy.
Main Results:
- Nine of thirteen histogram parameters showed significant differences between tumor and non-tumor groups.
- No significant difference in mean CT attenuation was observed between groups.
- Higher median histogram value was an independent predictor for distinguishing tumors, achieving an Area Under the Curve (AUC) of 0.785.
Conclusions:
- Histogram analysis of unenhanced CT provides valuable information for the differential diagnosis of incidental prevascular mediastinal lesions.
- This method can assist in differentiating thymic tumors from non-tumorous conditions.
- Further research may refine the role of CT-based radiomics in thymic lesion characterization.
Objective:
To determine whether histogram analysis based on unenhanced CT can play a role in the differential diagnosis of thymoma and lymphoma from thymic hyperplasia and cyst (mean CT attenuation > 10 HU).
Materials And Methods:
This retrospective study included consecutive asymptomatic participants who have prevascular mediastinal lesions incidentally detected by unenhanced CT between December 2013 and August 2020, and with definitive diagnosis by pathology or additional radiologic work-ups. A total of thirteen histogram parameters on enhanced CT were calculated for each lesion, then were compared between tumor (thymoma + lymphoma) and non-tumor (hyperplasia + cyst). Receiver operating characteristic analysis was conducted to investigate the performance of histogram parameter for identifying tumor.
Results:
The study population included 192 patients (106 men and 86 women) with a mean age of 50.5 years at the time of CT examination. Of them, 94 patients have tumor (87 thymomas and 7 lymphoma) and 98 have non-tumor (48 thymic hyperplasia and 50 cysts). Nine of the thirteen histogram parameters revealed significant difference between the two groups, including median, minimum, range, 10th percentile, 90th percentile, kurtosis, skewness, uniformity and entropy. No significant difference was observed in the mean CT attenuation between groups. Higher median was found to be independent predictors for distinguishing tumor from non-tumor, and can achieve an area under the curve (AUC) of 0.785 (95% confidence interval [95% IC], 0.720-0.841).
Conclusions:
Histogram analysis based on unenhanced CT may be able to provide some help in the differential diagnosis of incidental lesions in prevascular mediastinal.
Grand Support:
This study was sponsored by Natural Science Foundation of Shanghai (No. 21ZR1459700).
