Extracellular volume fraction measurement correlates with lymphocyte abundance in thymic epithelial tumors
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RESEARCH ARTICLE
Open Access
Extracellular volume fraction measurement correlates with lymphocyte abundance in thymic epithelial tumors Chao-Chun Chang1, Chia-Ying Lin2, Chang-Yao Chu3, Yi-Cheng Hsiung2, Ming-Tsung Chuang2, Yau-Lin Tseng1 and Yi-Ting Yen1,4*
Abstract Background: Recent advance in tissue characterization with parametric mapping imaging has the potential to be a novel biomarker for histopathologic correlation with thymic epithelial tumors (TETs). The purpose of our study is to evaluate MRI T1 mapping with the calculation of extracellular volume (ECV) fraction for histologic correlation with thymic epithelial tumor based on lymphocyte abundance. Methods: A retrospective study including 31 consecutive patients (14 men and 17 women, median age, 56 years; interquartile range, 12 years) with TETs was performed. The T1 values and ECV were assessed by using quantitative MRI mapping techniques. Mann-Whitney U test, Kruskal-Wallis H test, and receiver operating characteristic curve analyses were used to assess discrimination between different types of TETs based on lymphocyte abundance. Results: Extracellular volume was significantly higher in TETs with sparse lymphocyte, including type A, type B3, and thymic carcinoma, compared with those with abundant lymphocyte, including type B1, B2, and AB thymomas (42.5% vs 26.9%, respectively; p < 0.001). Extracellular volume was significantly higher in thymic carcinoma compared with low grade and high grade thymomas (48.6% vs 31.1% vs 27.6%, respectively; p = 0.002). Conclusions: T1 mapping with the calculation of extracellular volume (ECV) fraction correlate with the WHO histologic classification of thymic epithelial tumor based on lymphocyte abundance. Keywords: Extracellular space, Magnetic resonance imaging, Thymic epithelial tumor (TET), World Health Organization (WHO)
Introduction
* Correspondence: [email protected] 1 Division of Thoracic Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan 4 Division of Trauma and Acute Care Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng-Li Road, Tainan 704, Taiwan Full list of author information is available at the end of the article
Thymic epithelial tumors (TETs), including thymoma and thymic carcinoma, show a broad spectrum of histologic features and oncologic behavior. Several classifications have been proposed to correlate the histopathology and the clinical course of the TETs and to reflect their invasiveness and prognosis. The World Health Organization (WHO) histologic consensus classification,
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