European Radiology

, Volume 27, Issue 5, pp 1992–2001 | Cite as

Volume-based quantification using dual-energy computed tomography in the differentiation of thymic epithelial tumours: an initial experience

  • Suyon Chang
  • Jin HurEmail author
  • Dong Jin Im
  • Young Joo Suh
  • Yoo Jin Hong
  • Hye-Jeong Lee
  • Young Jin Kim
  • Kyunghwa Han
  • Dae Joon Kim
  • Chang Young Lee
  • Ha Young Shin
  • Byoung Wook Choi



To investigate the diagnostic value of dual-energy computed tomography (DECT) in differentiating between low- and high-risk thymomas and thymic carcinomas.


Our institutional review board approved this study, and patients provided informed consent. We prospectively enrolled 37 patients (20 males, mean age: 55.6 years) with thymic epithelial tumour. All patients underwent DECT. For quantitative analysis, two reviewers measured the following tumour parameters: CT attenuation value in contrast Hounsfield units (CHU), iodine-related HU and iodine concentration (mg/ml). Pathological results confirmed the final diagnosis.


Of the 37 thymic tumours, 23 (62.2 %) were low-risk thymomas, five (13.5 %) were high-risk thymomas and nine (24.3 %) were thymic carcinomas. According to quantitative analysis, iodine-related HU and iodine concentration were significantly different among low-risk thymomas, high-risk thymomas and thymic carcinomas (median: 29.78 HU vs. 14.55 HU vs. 19.95 HU, p = 0.001 and 1.92 mg/ml vs. 0.99 mg/ml vs. 1.18 mg/ml, p < 0.001, respectively).


DECT using a quantitative analytical method based on iodine concentration measurement can be used to differentiate among thymic epithelial tumours using single-phase scanning.

Key Points

IHU and IC were lower in high-risk thymomas/carcinomas than in low-risk thymomas

IHU and IC were lower in advanced-stage thymomas than in early-stage thymomas

Dual-energy CT helps differentiate among thymic epithelial tumours.


Thymoma Thymic carcinoma Mediastinal mass Dual-energy computed tomography Iodine concentration 



Contrast Hounsfield unit


Dual-energy computed tomography


Hounsfield unit


Iodine concentration


Iodine-related Hounsfield unit


Volume of interest



The scientific guarantor of this publication is Jin Hur, MD, PhD. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. This study was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (2012-R1A1A1013152). One of the authors has significant statistical expertise. Dr. Kyunghwa Han (Severance Hospital, Yonsei University College of Medicine) provided statistical advice in this study. Institutional Review Board approval was obtained. Written informed consent was obtained from all patients in this study. Methodology: prospective, diagnostic or prognostic study, performed at one institution.


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Copyright information

© European Society of Radiology 2016

Authors and Affiliations

  • Suyon Chang
    • 1
  • Jin Hur
    • 1
    Email author
  • Dong Jin Im
    • 1
  • Young Joo Suh
    • 1
  • Yoo Jin Hong
    • 1
  • Hye-Jeong Lee
    • 1
  • Young Jin Kim
    • 1
  • Kyunghwa Han
    • 2
  • Dae Joon Kim
    • 3
  • Chang Young Lee
    • 3
  • Ha Young Shin
    • 4
  • Byoung Wook Choi
    • 1
  1. 1.Department of Radiology and Research Institute of Radiological Science, Severance HospitalYonsei University College of MedicineSeoulRepublic of Korea
  2. 2.Yonsei Biomedical Research Institute, Department of Radiology, Research Institute of Radiological Science, Severance HospitalYonsei University College of MedicineSeoulRepublic of Korea
  3. 3.Department of Thoracic and Cardiovascular SurgeryYonsei University College of MedicineSeoulRepublic of Korea
  4. 4.Department of NeurologyYonsei University College of MedicineSeoulRepublic of Korea

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