Diagnostic accuracy of multidetector computed tomography scan in mediastinal masses assuming histopathological findings as gold standard
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Submission date: 2018-02-18
Acceptance date: 2018-03-27
Publication date: 2018-05-25
Pol J Radiol, 2018; 83: 234-242
Aim of the study was to: 1) present MDCT characteristics of different mediastinal mass lesions, 2) estimate proportion of benign and malignant mediastinal mass lesions based on MDCT findings, and 3) find out the diagnostic accuracy with sensitivity, specificity, positive predictive value, and negative predictive value of MDCT in mediastinal mass lesions assuming histopathology as gold standard.

Material and methods:
This study was an analysis of 60 patients who underwent MDCT scan for characterisation of mediastinal mass lesion, and subsequently imaging findings were verified with pathological diagnosis.

Out of 60 patients 65% were malignant and 35% were benign. Metastatic carcinoma was the leading diagnosis. Sensitivity of MDCT in this study came out to be 94%, specificity is 90%, with a positive predictive value of 94% and negative predictive value of 90% with diagnostic accuracy of 93%.

Mediastinal mass lesion can be accurately diagnosed with MDCT which is a non-invasive and easily available modality requiring clinical data for accurate diagnosis and management. Co-relation of MDCT findings with other imaging findings is complex and requires adequate clinical data for optimum diagnostic confidence.

Carter BW, Benveniste MF, Madan R, et al. ITMIG Classification of Mediastinal Compartments and Multidisciplinary Approach to Mediastinal Masses. Radiographics 2017; 37: 413-436.
Baram A, Tayeb ZA. Mediastinal Masses: Retrospective Single Center Based Study. J Cancer Sci Ther 2016; 8: 252-256.
Pulasani K, Narayanaswamy I, Ramprakash HV. Evaluation of Mediastinal Mass Lesions Using Multi-detector Row Computed.
Tomography and Correlation with Histopathological Diagnosis. Int J Sci Stud 2015; 3: 156-163.
Dixit R, Shah NS, Goyal M, et al. Diagnostic evaluation of mediastinal lesions: Analysis of 144 cases. Lung India 2017; 34: 341-348.
Kaur H, Tiwari P, Dugg P, et al. Computed tomographic evaluation of mediastinal masses/lesions with contrast enhancement and correlation with pathological diagnosis – a study of 120 cases. J Biomed Graph Comput 2014; 4: 28-35.
Adler OB, Rosenberger A, Peleg H. Fine-needle aspiration biopsy of mediastinal masses: Evaluation of 136 experiences. AJR Am J Roentgenol 1983; 140: 893-896.
Dubashi B, Cyriac S, Tenali SG. Clinicopathological analysis and outcome of primary mediastinal malignancies. A report of 91cases from a single institute. Ann Thorac Med 2009; 4: 140-142.
Araki T, Nishino M, Gao W, et al. Anterior mediastinal masses in the Framingham Heart Study: Prevalence and CT image characteri­stics. Eur J Radiol Open 2015; 2: 26-31.
Aroor AR, Prakasha SR, Seshadri S, et al. A study of clinical characteristicsof mediastinal mass. J Clin Diagn Res 2014; 8: 77-80.
Liu T, Al-Kzayer LF, Xie X, et al. Mediastinal lesions across the age spectrum: a clinicopathological comparison between pediatric and adult patients. Oncotarget 2017; 8: 59845-59853.
ee EY. Evaluation of non-vascular mediastinal masses in infants and children: an evidence-based practical approach. Pediatr Radiol 2009; 39 Suppl 2: S184-S190.
aeber GM, Shriver CD, Albus RA, et al. The use ofcomputed tomography in the evaluation of mediastinal masses. J Thorac Cardiovasc Surg 1986; 91: 662-666.
Siegel MJ, Sagel SS, Reed K. The value of computed tomography in the diagnosis and management of pediatric mediastinal abnormalities. Radiology 1982; 142: 149-155.
Ranganath SH, Lee EY, Restrepo R, et al. Mediastinal masses in children. Am J Roentgenol 2012; 198: W197-W216.
Nasseri F, Eftekhari F. Clinical and radiologic review of the normal and abnormal thymus: pearls and pitfalls. Radiographics 2010; 30: 413-428.
Merten DF. Diagnostic imaging of mediastinal masses in children. Am J Roentgenol 1992; 158: 825-832.
Meza MP, Benson M, Slovis TL. Imaging of mediastinal masses in children. Radiol Clin North Am 1993; 31: 583-604.
Moeller KH, Rosado-de-Christenson ML, Templeton PA. Mediastinal mature teratoma: imaging features. AJR Am J Roentgenol 1997; 169: 985-990.
Rosado-de-Christenson ML, Templeton PA, Moran CA. From the archives of the AFIP. Mediastinal germ cell tumors: radiologic and pathologic correlation. Radiographics 1992; 12: 1013-1030.
Tomiyama N, Honda O, Tsubamoto M, et al. Anterior mediastinal tumors: diagnostic accuracy of CT and MRI. Eur J Radiol 2009; 69: 280-288.
Kim WS, Moon WK, Kim IO, et al. Pulmonary tuberculosis in children: Evaluation with CT. AJR Am J Roentgenol 1997; 168: 1005-1009.
Van Dyck P, Vanhoenacker FM, Van den Brande P, De Schepper AM. Imaging of pulmonary tuberculosis. Eur Radiol 2003; 13: 1771-1785.
Shahrzad M, Lee TS, Silva M, et al. Anterior Mediastinal Masses. AJR Am J Roentgenol 2014; 203: W128-W138.
Nakazono T, White CS, Yamasaki F, et al. MRI findings of mediastinal neurogenic tumors. AJR Am J Roentgenol 2011; 197: W643-W652.
De Backer AI, Mortelé KJ, Vanschoubroeck IJ, et al. Tuberculosis of the spine: CT and MR imaging features. JBR-BTR 2005; 88: 92-97.
Engin G, Acunaş B, Acunaş G, Tunaci M. Imaging of extrapulmonary tuberculosis. Radiographics 2000; 20: 4713.
Zhang WD, Zhao LL, Huang XB, et al. Computed tomography imaging of anterior and middle mediastinal Ewing sarcoma/primitive neuroectodermal tumors. J Thorac Imaging 2010; 25: 168-172.
von Sinner WN, Linjawi T, al Watban JA. Mediastinal hydatid disease: report of three cases. J Can Assoc Radiol 1990; 41: 79-82.
Zidi A, Zannad-Hantous S, Mestiri I, et al. Hydatid cyst of the mediastinum: 14 case reports. J Radiol 2006; 87 (12 Pt 1): 1869-1874.
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