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Thorac Cardiovasc Surg 2017; 65(03): 244-249
DOI: 10.1055/s-0036-1583765
Original Thoracic
Georg Thieme Verlag KG Stuttgart · New York

Impact of Surgical Evaluation of Additional Cine Magnetic Resonance Imaging for Advanced Thymoma with Infiltration of Adjacent Structures: The Thoracic Surgeon's View

Michael Ried
1   Department of Thoracic Surgery, University Medical Center Regensburg, Regensburg, Germany
,
Stefanie Hnevkovsky
1   Department of Thoracic Surgery, University Medical Center Regensburg, Regensburg, Germany
,
Reiner Neu
1   Department of Thoracic Surgery, University Medical Center Regensburg, Regensburg, Germany
,
Marietta von Süßkind-Schwendi
1   Department of Thoracic Surgery, University Medical Center Regensburg, Regensburg, Germany
,
Andrea Götz
2   Department of Radiology, University Medical Center Regensburg, Regensburg, Germany
,
Okka W. Hamer
2   Department of Radiology, University Medical Center Regensburg, Regensburg, Germany
,
Berthold Schalke
3   Department of Neurology, University of Regensburg at the District Medical Center, Regensburg, Germany
,
Hans-Stefan Hofmann
1   Department of Thoracic Surgery, University Medical Center Regensburg, Regensburg, Germany
4   Department of Thoracic Surgery, Hospital Barmherzige Brüder Regensburg, Regensburg, Germany
› Author Affiliations
Further Information

Publication History

27 July 2015

03 April 2016

Publication Date:
13 May 2016 (online)

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Abstract

Background Preoperative 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 Methods This prospective study included patients with advanced thymoma, who underwent surgical resection. All patients received preoperative computed tomography (CT) scan and cine MRI.

Results Tumor 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%).

Conclusion Cine MRI seems to improve the accuracy of preoperative staging of advanced thymoma regarding infiltration of cardiovascular structures and supports the surgical approach.

Keywords

cine magnetic resonance imaging - thymoma - thymic carcinoma - cardiovascular infiltration
 

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