• Scherwin Mahmoudi, Leon D Gruenewald, Katrin Eichler, Simon S Martin, Christian Booz, Simon Bernatz, Maximilian Lahrsow, Ibrahim Yel, Jennifer Gotta, Teodora Biciusca, Hanin Mohammed, ZiegengeistNicole SuarezNSDepartment of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany., Katerina Torgashov, Renate M Hammerstingl, Christof M Sommer, Christophe Weber, Haidara Almansour, Giuseppe Bucolo, Tommaso D'Angelo, Jan-Erik Scholtz, Tatjana Gruber-Rouh, Thomas J Vogl, and Vitali Koch.
• Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany.
• Eur. J. Clin. Invest. 2023 Dec 1; 53 (12): e14075e14075.

BackgroundTo investigate the potential of radiomic features and dual-source dual-energy CT (DECT) parameters in differentiating between benign and malignant mediastinal masses and predicting patient outcomes.MethodsIn this retrospective study, we analysed data from 90 patients (38 females, mean age 51 ± 25 years) with confirmed mediastinal masses who underwent contrast-enhanced DECT. Attenuation, radiomic features and DECT-derived imaging parameters were evaluated by two experienced readers. We performed analysis of variance (ANOVA) and Chi-square statistic tests for data comparison. Receiver operating characteristic curve analysis and Cox regression tests were used to differentiate between mediastinal masses.ResultsOf the 90 mediastinal masses, 49 (54%) were benign, including cases of thymic hyperplasia/thymic rebound (n = 10), mediastinitis (n = 16) and thymoma (n = 23). The remaining 41 (46%) lesions were classified as malignant, consisting of lymphoma (n = 28), mediastinal tumour (n = 4) and thymic carcinoma (n = 9). Significant differences were observed between benign and malignant mediastinal masses in all DECT-derived parameters (p ≤ .001) and 38 radiomic features (p ≤ .044) obtained from contrast-enhanced DECT. The combination of these methods achieved an area under the curve of .98 (95% CI, .893-1.000; p < .001) to differentiate between benign and malignant masses, with 100% sensitivity and 91% specificity. Throughout a follow-up of 1800 days, a multiparametric model incorporating radiomic features, DECT parameters and gender showed promising prognostic power in predicting all-cause mortality (c-index = .8 [95% CI, .702-.890], p < .001).ConclusionsA multiparametric approach combining radiomic features and DECT-derived imaging biomarkers allows for accurate and noninvasive differentiation between benign and malignant masses in the anterior mediastinum.© 2023 The Authors. European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation.

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