La radiologia medica

, Volume 123, Issue 5, pp 345–350 | Cite as

Analysis of CT features and quantitative texture analysis in patients with thymic tumors: correlation with grading and staging

  • Angelo Iannarelli
  • Beatrice Sacconi
  • Francesca Tomei
  • Marco Anile
  • Flavia Longo
  • Mario Bezzi
  • Alessandro Napoli
  • Luca Saba
  • Michele Anzidei
  • Giulia D’Ovidio
  • Roberto Scipione
  • Carlo Catalano



To evaluate potential relationship between qualitative CT features, quantitative texture analysis (QTA), histology, WHO staging, Masaoka classification and myasthenic syndrome in patients with thymic tumors.

Materials and methods

Sixteen patients affected by histologically proven thymic tumors were retrospectively included in the study population. Clinical information, with special regard to myasthenic syndrome and serological positivity of anti-AchR antibodies, were recorded. Qualitative CT evaluation included the following parameters: (a) location; (b) tumor edges; (c) necrosis; (d) pleural effusion; (e) metastases; (f) chest wall infiltration; (g) tumor margins. QTA included evaluation of “Mean” (M), “Standard Deviation” (SD), “Kurtosis” (K), “Skewness” (S), “Entropy” (E), “Shape from Texture” (TX_sigma) and “average of positive pixels” (MPP). Pearson–Rho test was used to evaluate the relationship of continuous non-dichotomic parameters, whereas Mann–Whitney test was used for dichotomic parameters.


Histological evaluation demonstrated thymoma in 12 cases and thymic carcinoma in 4 cases. Tumor necrosis was significantly correlated with QTA Mean (p = 0.0253), MPP (p = 0.0417), S (p = 0.0488) and K (p = 0.0178). WHO staging was correlated with Mean (p = 0.0193), SD (p = 0.0191) and MPP (p = 0.0195). Masaoka classification was correlated with Mean (p = 0.0322), MPP (p = 0.0315), skewness (p = 0.0433) and Kurtosis (p = 0.0083). Myasthenic syndrome was significantly associated with Mean (p = 0.0211) and MPP (p = 0.0261), whereas tumor size was correlated with Mean (p = 0.0241), entropy (p = 0.0177), MPP (p = 0.0468), skewness (p = 0.009) and Kurtosis (p = 0.006).


Our study demonstrates significant relationship between radiomics parameters, histology, grading and clinical manifestations of thymic tumors.


Quantitative texture analysis Computed tomography Thymic neoplasm Masaoka WHO staging system 



No funding was received.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Italian Society of Medical Radiology 2018

Authors and Affiliations

  • Angelo Iannarelli
    • 1
  • Beatrice Sacconi
    • 1
  • Francesca Tomei
    • 1
  • Marco Anile
    • 2
  • Flavia Longo
    • 3
  • Mario Bezzi
    • 1
  • Alessandro Napoli
    • 1
  • Luca Saba
    • 4
  • Michele Anzidei
    • 1
  • Giulia D’Ovidio
    • 1
  • Roberto Scipione
    • 1
  • Carlo Catalano
    • 1
  1. 1.Department of Radiological, Oncological and Anatomopathological Sciences - Radiology“Sapienza” University of RomeRomeItaly
  2. 2.Department of Thoracic Surgery“Sapienza” University of RomeRomeItaly
  3. 3.Department of Radiological, Oncological and Anatomopathological Sciences - Oncology“Sapienza” University of RomeRomeItaly
  4. 4.Department of RadiologyAzienda Ospedaliero Universitaria (A.O.U.), di Cagliari e Polo di MonserratoMonserratoItaly

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