title: Chemical shift and diffusion-weighted magnetic resonance imaging of the anterior mediastinum in oncology: Current clinical applications in qualitative and quantitative assessment.
abstract: Recently, the use of magnetic resonance (MR) in clinical practice for the evaluation of the anterior mediastinum has considerably increased due to technological improvements and standardization of thoracic protocols. Currently, MR imaging is increasingly seen as a useful problem-solving modality, especially in equivocal cases at computed tomography, with the advantage of a higher contrast resolution and no radiation exposure. Chemical shift and diffusion-weighted MR are helpful in tissue characterization and present advantages over conventional MR imaging, first in providing quantitative data, without the need for the administration of contrast medium. By detecting microscopic fat in tissue, chemical shift imaging is useful for differentiating normal thymus and rebound hyperplasia from cancer tissue at diagnosis and after chemotherapy in oncologic patients, and for distinguishing lymphoid hyperplasia from thymoma in autoimmune diseases such as myasthenia gravis. Diffusion-weighted MR reflects diffusivity of water molecules within tissue and is increasingly used as a cancer biomarker, even in the thorax, for the detection and characterization of tumors, for their differentiation from benign conditions, and for monitoring treatment response. In this review, based on the current literature, technical considerations about image acquisition and data analysis of chemical shift and diffusion-weighted MR are discussed along with clinical applications in the field of benign and malignant disease of the anterior mediastinum.
authors.affiliation: Department of Radiology, San Luigi Gonzaga University Hospital, Orbassano, Torino, Italy. Electronic address: adriano.priola@inwind.it.
authors.forename: Adriano Massimiliano
authors.initials: AM
authors.lastname: Priola
authors.affiliation: Department of Radiology, San Luigi Gonzaga University Hospital, Orbassano, Torino, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Gned
authors.affiliation: Department of Radiology, San Luigi Gonzaga University Hospital, Orbassano, Torino, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Veltri
authors.affiliation: Department of Radiology, San Luigi Gonzaga University Hospital, Orbassano, Torino, Italy.
authors.forename: Sandro Massimo
authors.initials: SM
authors.lastname: Priola
mesh_terms: D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D006801:Humans; D006965:Hyperplasia; D008479:Mediastinal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D008482:Mediastinum / Q000000981:diagnostic imaging / Q000473:pathology*; D000072078:Positron Emission Tomography Computed Tomography; D013950:Thymus Gland / Q000000981:diagnostic imaging / Q000473:pathology
keywords: Anterior mediastinum; Chemical shift imaging; Diffusion-weighted imaging; Hyperplasia; Thymus; Tumor