An Investigational Scan (MRI) in Imaging Patients With Newly-Diagnosed or Recurrent Thymoma

Study Overview
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Brief Summary
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This trial studies the accuracy of a magnetic resonance imaging (MRI) scan in imaging the inside of the chest in patients with thymoma that is newly diagnosed or has come back. An MRI scan may be able to detect if and how far the tumor has spread more accurately than a standard computed tomography (CT) scan.

Detailed Description
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PRIMARY OBJECTIVES: I. To determine whether thymoma staging by MRI is as accurate as staging by CT as compared to surgical staging. SECONDARY OBJECTIVES: I. To determine whether evaluation of phrenic nerve paralysis by functional MRI is as accurate as the fluoroscopic sniff test as compared to surgical evaluation of phrenic nerve involvement. II. To determine whether fast novel MRI sequences are as accurate as conventional MRI sequences for staging thymoma, when comparing to surgical staging. OUTLINE: Patients undergo an MRI scan over 45-60 minutes and a diaphragm fluoroscopy 30 days before surgery.

Official Title
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Can MRI Replace CT in the Evaluation of Thymoma?

Conditions
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Recurrent Malignant Thymoma, Thymoma

Intervention / Treatment
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* Procedure: Diaphragm Fluoroscopy
* Procedure: Magnetic Resonance Imaging


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All adult patients scheduled to meet with a thoracic surgeon from MD Anderson Cancer Center (ACC) for resection of newly diagnosed thymoma or thymoma recurrence in the chest and scheduled for surgery Exclusion Criteria: Children, defined as individuals younger than 18 years old on the preoperative visit with the thoracic surgeon Pregnant patients Patients unable to understand the consent form Patients with metal within the chest and pacemakers Patients with a known allergic reaction to gadolinium, who will have their MRI performed without contrast Patients with glomerular filtration rate (GFR) < 60 ml/min, who will have their MRI performed without contrast Patients with an allergy to iodinated contrast material will follow departmental routine policy, that is those with anaphylaxis will have their CT performed without intravenous contrast and others will be prepped as for departmental guidelines for routine chest CT Patients with abnormal renal function will have their CT study perform as per DI's iodinated contrast administration guidelines, and no contrast will be administered with GFR lower than 30 ml/min

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Diagnostic (MRI, diaphragm fluoroscopy)<br>Patients undergo an MRI scan over 45-60 minutes and a diaphragm fluoroscopy 30 days before surgery. | Procedure: Diaphragm Fluoroscopy<br>* Undergo diaphragm fluoroscopy<br>* Other names: Sniff Test;Procedure: Magnetic Resonance Imaging<br>* Undergo MRI<br>* Other names: Nuclear Magnetic Resonance Imaging;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Accuracy of magnetic resonance imaging (MRI) staging | Will be compared to staging done by computed tomography (CT). McNemar's test will be used to compare the accuracy for the following five sets of comparisons: spin echo (SE) T1 compared versus (vs.) liver acquisition with volume acquisition (LAVA)+ in-phase (IP)/out-of-phase (OP), Dixon versus fast spin echo (FSE) T2, LAVA+IP/OP+Dixon vs. SET1+FSET2, LAVA+IP/OP+Dixon vs. computed tomography (CT) scan, and SET1+FSET2 vs. CT scan. A p value less than 0.05 will be defined as significant. A p value less than 0.05 will be defined as significant. | Up to 10 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Accuracy of phrenic nerve paralysis by functional MRI | Will be evaluated against the fluoroscopic sniff test and compared to surgical evaluation of phrenic nerve involvement. The outcome is the binary indicator of whether the phrenic nerve is involved. The accuracy rate will be calculated for each of the three tested methods. And the method with the highest accuracy will be compared with the method with the medium accuracy and the method with least accuracy separately, using McNemar's test. | Up to 10 years | 
| Accuracy of fast novel MRI sequences | Will be evaluated against conventional MRI sequences for staging thymoma when compared to surgical staging. Will use the pathological stages as gold standard and calculate accuracy for the new shorter MRI sequences and current MRI sequences methods. Accuracy will be compared between two MRI techniques using McNemar's test. And the following five sets of comparisons will be tested: SE T1 compared vs. LAVA+ IP/OP, Dixon versus FSE T2, LAVA+IP/OP+Dixon vs. SET1+FSET2, LAVA+IP/OP+Dixon vs. CT scan, and SET1+FSET2 vs. CT scan. A p value less than 0.05 will be defined as significant. | Up to 10 years |