{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:57:19Z","timestamp":1792083439855,"version":"4.4.0"},"reference-count":37,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2023,12,13]],"date-time":"2023-12-13T00:00:00Z","timestamp":1702425600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT)","award":["RS-2022-00166193"],"award-info":[{"award-number":["RS-2022-00166193"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Purpose: To investigate the diffusion-weighted imaging (DWI) findings and apparent diffusion coefficient (ADC) value of the thymus in children under the age of 13 who have non-thymic neoplasms. Materials and Methods: From January 2021 to April 2023, a single-center retrospective study analyzed consecutive 191 thoracic MRI scans with DWI from 67 children (&lt;13 years) with non-thymic neoplasms. The scans were categorized based on the presence of restricted diffusion on DWI. We analyzed the demographics, laboratory data, and MR findings of the thymus. Statistical differences were assessed using generalized estimating equations. Results: Forty-five percent (86\/191) of the scans exhibited restricted diffusion in the thymus: multifocal (n = 65; 76%), focal (n = 19; 22%), and diffuse (n = 2; 2%) patterns. The restricted diffusion group demonstrated higher absolute lymphocyte counts, more prominent thymus sizes, and higher frequency of off-treatment status compared to the unrestricted diffusion group (p&gt;0.05). The mean ADC value across all 191 scans was 1.80 \u00d7 10\u22123 mm2\/s. No significant difference was observed in the ADC value related to restricted diffusion patterns, the MRI vendors, or the age at the time of the scan. Conclusions: Restricted diffusion was observed in 45% of the thymus in children with non-thymic neoplasms, with a mean ADC value of 1.80 \u00d7 10\u22123 mm2\/s. Recognizing the DWI findings can prevent unnecessary invasive procedures, alleviating concerns for patients and families.<\/jats:p>","DOI":"10.3390\/diagnostics13243654","type":"journal-article","created":{"date-parts":[[2023,12,13]],"date-time":"2023-12-13T08:55:16Z","timestamp":1702457716000},"page":"3654","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Diffusion-Weighted MR Imaging of the Thymus in Children with Non-Thymic Neoplasms"],"prefix":"10.3390","volume":"13","author":[{"given":"Sook Min","family":"Hwang","sequence":"first","affiliation":[{"name":"Department of Radiology, Hallym University Kangnam Sacred Heart Hospital, Seoul 07441, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji Eun","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06531, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"So-Young","family":"Yoo","sequence":"additional","affiliation":[{"name":"Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06531, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji Hye","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06531, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sun-Young","family":"Baek","sequence":"additional","affiliation":[{"name":"Biomedical Statistics Center and Research Institute for Future Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7879-3114","authenticated-orcid":false,"given":"Sung-Hoon","family":"Moon","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7796-1307","authenticated-orcid":false,"given":"Tae Yeon","family":"Jeon","sequence":"additional","affiliation":[{"name":"Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06531, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,12,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1622","DOI":"10.2214\/AJR.06.1403","article-title":"Diffusion-weighted MRI in the body: Applications and challenges in oncology","volume":"188","author":"Koh","year":"2007","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1148\/radiol.11110474","article-title":"Whole-body diffusion-weighted MR imaging in cancer: Current status and research directions","volume":"261","author":"Padhani","year":"2011","journal-title":"Radiology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1007\/s002470050351","article-title":"The thymus: From past misconception to present recognition","volume":"28","author":"Leonidas","year":"1998","journal-title":"Pediatr. Radiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"491","DOI":"10.2214\/ajr.138.3.491","article-title":"Normal thymus: CT characteristics in subjects under age 20","volume":"138","author":"Heiberg","year":"1982","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/S1095-0397(00)00049-2","article-title":"18F-FDG Uptake in the Anterior Mediastinum. Physiologic Thymic Uptake or Disease?","volume":"3","author":"Rini","year":"2000","journal-title":"Clin. Positron Imaging"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2015","DOI":"10.1242\/dev.087320","article-title":"Dynamics of thymus organogenesis and colonization in early human development","volume":"140","author":"Farley","year":"2013","journal-title":"Development"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.anndiagpath.2003.11.006","article-title":"Histologic and molecular assessment of human thymus","volume":"8","author":"Hale","year":"2004","journal-title":"Ann. Diagn. Pathol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"249","DOI":"10.2214\/ajr.145.2.249","article-title":"The thymus: Reexamination of age-related changes in size and shape","volume":"145","author":"Francis","year":"1985","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1427","DOI":"10.1007\/s00330-017-5142-z","article-title":"Nonsuppressing normal thymus on chemical-shift MR imaging and anterior mediastinal lymphoma: Differentiation with diffusion-weighted MR imaging by using the apparent diffusion coefficient","volume":"28","author":"Priola","year":"2018","journal-title":"Eur. Radiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1148\/radiol.14132665","article-title":"Differentiation of rebound and lymphoid thymic hyperplasia from anterior mediastinal tumors with dual-echo chemical-shift MR imaging in adulthood: Reliability of the chemical-shift ratio and signal intensity index","volume":"274","author":"Priola","year":"2015","journal-title":"Radiology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.2214\/ajr.180.5.1801265","article-title":"Characterization of the normal and hyperplastic thymus on chemical-shift MR imaging","volume":"180","author":"Takahashi","year":"2003","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1002\/jmri.20407","article-title":"Evaluation of normal fatty replacement of the thymus with chemical-shift MR imaging for identification of the normal thymus","volume":"22","author":"Inaoka","year":"2005","journal-title":"J. Magn. Reson. Imaging"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1016\/j.crad.2021.02.017","article-title":"The paediatric thymus: Recognising normal and ectopic thymic tissue","volume":"76","author":"Wee","year":"2021","journal-title":"Clin. Radiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1007\/s11604-005-0029-3","article-title":"Ectopic cervical thymus in an infant","volume":"24","author":"Liu","year":"2006","journal-title":"Radiat. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1148\/radiology.142.1.7053521","article-title":"Computed tomography of the normal thymus","volume":"142","author":"Baron","year":"1982","journal-title":"Radiology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"101837","DOI":"10.1016\/j.smim.2023.101837","article-title":"Thymus aging and immune reconstitution, progresses and challenges","volume":"70","author":"Li","year":"2023","journal-title":"Semin. Immunol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1259\/bjr.74.885.740821","article-title":"FDG uptake in the morphologically normal thymus: Comparison of FDG positron emission tomography and CT","volume":"74","author":"Nakahara","year":"2001","journal-title":"Br. J. Radiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1097\/00004728-198707000-00018","article-title":"CT appearances of the normal and abnormal thymus in childhood","volume":"11","author":"Siegel","year":"1987","journal-title":"J. Comput. Assist. Tomogr."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1148\/radiology.172.2.2748817","article-title":"Normal and abnormal thymus in childhood: MR imaging","volume":"172","author":"Siegel","year":"1989","journal-title":"Radiology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"W1","DOI":"10.2214\/AJR.15.15303","article-title":"Pitfalls in the Imaging and Interpretation of Benign Thymic Lesions: How Thymic MRI Can Help","volume":"206","author":"McInnis","year":"2016","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1016\/j.clinimag.2014.05.012","article-title":"Diagnostic and functional imaging of thymic and mediastinal involvement in lymphoproliferative disorders","volume":"38","author":"Priola","year":"2014","journal-title":"Clin. Imaging"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1148\/rg.302095131","article-title":"Clinical and radiologic review of the normal and abnormal thymus: Pearls and pitfalls","volume":"30","author":"Nasseri","year":"2010","journal-title":"Radiographics"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"985735","DOI":"10.3389\/fonc.2022.985735","article-title":"Role of diffusion-weighted MRI in differentiation between benign and malignant anterior mediastinal masses","volume":"12","author":"Thuy","year":"2022","journal-title":"Front. Oncol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"241","DOI":"10.2214\/ajr.141.2.241","article-title":"Age-related changes in the thymus gland: CT-pathologic correlation","volume":"141","author":"Moore","year":"1983","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1148\/radiology.158.2.3941858","article-title":"Normal thymus: Assessment with MR and CT","volume":"158","author":"Webb","year":"1986","journal-title":"Radiology"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1097\/RLI.0000000000000120","article-title":"Chemical-shift and diffusion-weighted magnetic resonance imaging of thymus in myasthenia gravis: Usefulness of quantitative assessment","volume":"50","author":"Priola","year":"2015","journal-title":"Investig. Radiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"269","DOI":"10.2214\/ajr.149.2.269","article-title":"Thymic atrophy and regrowth in response to chemotherapy: CT evaluation","volume":"149","author":"Choyke","year":"1987","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"471","DOI":"10.2214\/AJR.13.11210","article-title":"Imaging characteristics of pathologically proven thymic hyperplasia: Identifying features that can differentiate true from lymphoid hyperplasia","volume":"202","author":"Araki","year":"2014","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"100207","DOI":"10.1016\/j.modpat.2023.100207","article-title":"Thymic Parenchymal Hyperplasia","volume":"36","author":"Suster","year":"2023","journal-title":"Mod. Pathol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1016\/0003-4975(89)90131-8","article-title":"True thymic hyperplasia: A clinicopathological study","volume":"47","author":"Ricci","year":"1989","journal-title":"Ann. Thorac. Surg."},{"key":"ref_31","first-page":"41","article-title":"Thymus size in infants from birth until 24 months of age evaluated by ultrasound. A longitudinal prediction model for the thymic index","volume":"40","author":"Hasselbalch","year":"1999","journal-title":"Acta Radiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1111\/j.1399-3038.2004.00032.x","article-title":"T-lymphocyte subsets, thymic size and breastfeeding in infancy","volume":"15","author":"Jeppesen","year":"2004","journal-title":"Pediatr. Allergy Immunol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"849","DOI":"10.2967\/jnumed.108.058586","article-title":"Physiologic thymic uptake of 18F-FDG in children and young adults: A PET\/CT evaluation of incidence, patterns, and relationship to treatment","volume":"50","author":"Jerushalmi","year":"2009","journal-title":"J. Nucl. Med."},{"key":"ref_34","first-page":"433","article-title":"Comparison of apparent diffusion coefficient values among different MRI platforms: A multicenter phantom study","volume":"19","author":"Kivrak","year":"2013","journal-title":"Diagn. Interv. Radiol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1002\/jmri.22395","article-title":"Diffusion-weighted imaging of the abdomen at 3.0 Tesla: Image quality and apparent diffusion coefficient reproducibility compared with 1.5 Tesla","volume":"33","author":"Rosenkrantz","year":"2011","journal-title":"J. Magn. Reson. Imaging"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1148\/radiol.09090891","article-title":"Variability of renal apparent diffusion coefficients: Limitations of the monoexponential model for diffusion quantification","volume":"254","author":"Zhang","year":"2010","journal-title":"Radiology"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1148\/radiol.13130819","article-title":"Diffusion-weighted MR imaging of upper abdominal organs: Field strength and intervendor variability of apparent diffusion coefficients","volume":"270","author":"Donati","year":"2014","journal-title":"Radiology"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/13\/24\/3654\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:38:02Z","timestamp":1760132282000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/13\/24\/3654"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,13]]},"references-count":37,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["diagnostics13243654"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics13243654","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,13]]}}}