Work

The value of multiparameter MRI in the preoperative assessment of thymoma invasiveness

Year: 2026

Type: article

Abstract: Objective To investigate the diagnostic value of imaging features derived from multi-parameter MRI for preoperative assessment of thymoma invasiveness. Materials and methods Forty-two patients with pathologically proven thymoma were enrolled retrospectively. Patients were classified into non-invasive and invasive groups based on postoperative histopathology. Morphological features (size, contour, signal homogeneity, fat infiltration) and quantitative features (ADCmin, ADCmean and ADCmax) were analyzed. Statistical comparisons were performed using Student's t-test, chi-square test, and receiver operating characteristic (ROC) analysis. The performance of these features was evaluated by accuracy, sensitivity, specificity, and area under the curve (AUC). Results Significant differences were observed between non-invasive (n = 25) and invasive (n = 17) thymomas in diameter (3.8 ± 1.3 cm vs 5.9 ± 2.0 cm, p < 0.001), lobulated contour (40% vs 82.4%, p = 0.005), signal heterogeneity (44% vs 94.1%, p < 0.001), and surrounding fat infiltration (48% vs 100%, p < 0.001). Invasive thymomas showed significantly lower ADCmin (1.35 ± 0.52 vs 0.87 ± 0.38 × 10 −3 mm 2 /s, p = 0.003) and ADCmean values (1.63 ± 0.57 vs 1.16 ± 0.48 × 10 −3 mm 2 /s, p = 0.009). Multivariable logistic regression analysis revealed that the combination of ADCmin, ADCmean and diameter had the highest AUC of 0.82 (95% CI: 0.69-0.96) for identifying invasiveness of thymoma, with a sensitivity of 84% and a specificity of 76%. Conclusion Multiparameter MRI, which integrates both morphological and quantitative features, is valuable for preoperatively predicting thymoma invasiveness. A lobulated contour, heterogeneous signal, surrounding fat infiltration, and lower ADC values are significant indicators of aggressive behavior.

Source: Asian Journal of Surgery

DOI: 10.1016/j.asjsur.2026.05.015