title: Impact of Surgical Evaluation of Additional Cine Magnetic Resonance Imaging for Advanced Thymoma with Infiltration of Adjacent Structures: The Thoracic Surgeon's View.
abstract: BackgroundPreoperative radiological assessment is important for clarification of surgical operability for advanced thymic tumors. Objective was to determine the feasibility of magnetic resonance imaging (MRI) with cine sequences for evaluation of cardiovascular tumor invasion.Patients and MethodsThis prospective study included patients with advanced thymoma, who underwent surgical resection. All patients received preoperative computed tomography (CT) scan and cine MRI.ResultsTumor infiltration was surgically confirmed in the pericardium (n= 12), myocardium (n= 1), superior caval vein (SCV;n= 3), and aorta (n= 2). A macroscopic complete resection was possible in 10 patients, whereas 2 patients with aortic or myocardial tumor invasion had R2 resection. The positive predictive value (PPV) was 50% for cine MRI compared with 0% for CT scan regarding myocardial tumor infiltration. The PPV for tumor infiltration of the aorta was 50%, with a higher sensitivity for the CT scan (100 vs. 50%). Infiltration of the SCV could be detected slightly better with cine MRI (PPV 75 vs. 66.7%).ConclusionCine MRI seems to improve the accuracy of preoperative staging of advanced thymoma regarding infiltration of cardiovascular structures and supports the surgical approach.
authors.affiliation: Department of Thoracic Surgery, University Medical Center Regensburg, Regensburg, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Ried
authors.affiliation: Department of Thoracic Surgery, University Medical Center Regensburg, Regensburg, Germany.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Hnevkovsky
authors.affiliation: Department of Thoracic Surgery, University Medical Center Regensburg, Regensburg, Germany.
authors.forename: Reiner
authors.initials: R
authors.lastname: Neu
authors.affiliation: Department of Thoracic Surgery, University Medical Center Regensburg, Regensburg, Germany.
authors.forename: Marietta
authors.initials: M
authors.lastname: von Süßkind-Schwendi
authors.affiliation: Department of Radiology, University Medical Center Regensburg, Regensburg, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Götz
authors.affiliation: Department of Radiology, University Medical Center Regensburg, Regensburg, Germany.
authors.forename: Okka W
authors.initials: OW
authors.lastname: Hamer
authors.affiliation: Department of Neurology, University of Regensburg at the District Medical Center, Regensburg, Germany.
authors.forename: Berthold
authors.initials: B
authors.lastname: Schalke
authors.affiliation: Department of Thoracic Surgery, University Medical Center Regensburg, Regensburg, Germany.
authors.forename: Hans-Stefan
authors.initials: HS
authors.lastname: Hofmann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D005858:Germany; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging / Q000379:methods*; D018579:Patient Selection; D010496:Pericardium / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D011237:Predictive Value of Tests; D011446:Prospective Studies; D066231:Surgeons; D013934:Thymectomy; D013945:Thymoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D013953:Thymus Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014683:Vena Cava, Superior / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery