Diagnostic and functional imaging of thymic and mediastinal involvement in lymphoproliferative disorders

Lymphoproliferative disorders of the anterior mediastinum may involve the thymus or lymph nodes as part of disseminated disease or as an isolated site. Imaging is crucial in managing patients with mediastinal lymphoma and is employed in pretreatment assessment, midtreatment evaluation of response, posttreatment restaging, and surveillance during follow-up. For decades, computed tomography (CT) has been the standard imaging technique, although in the last years, positron emission tomography (PET)–CT and magnetic resonance imaging (MRI) have been introduced. We discuss the role of different imaging techniques in the assessment of patients with mediastinal lymphoma, focusing on novel aspects of PET–CT and diffusion-weighted/MRI.