| ［Purposes］To analyze the detection rate and imaging characteristics of anterior mediastinal masses incidentally detected by low-dose computed tomography (LDCT) screening conducted under the Jiangxi Urban Cancer Early Detection and Treatment Project from 2019 to 2023, and to provide evidence for the standardized management of this "by-product" in screening scenarios.［Methods］A retrospective analysis was performed on LDCT data from 11,564 high-risk individuals among permanent residents of Jiangxi Province aged 45–74 years who underwent cancer risk assessment. Twenty-four cases with newly identified anterior mediastinal masses were included. Baseline characteristics, conventional CT features, and radiomic parameters were recorded. Differences between lesions ≤3cm and >3cm in maximum diameter were compared. ［Results］The detection rate of anterior mediastinal masses was 0.21% (24/11,564). The mean age of patients was 63.0 ± 7.1 years, with a female predominance (66.7%). The mean maximum diameter of the lesions was 32.3 ±15.9mm, with lesions ≤3cm and >3cm each accounting for 50%. Conventional CT revealed irregular morphology in 62.5% of cases, lobulation in 33.3%, clear margins in 83.3%, and calcification in only 12.5%. The mean CT value was 32.0 ±18.3HU. Radiomic analysis demonstrated a strong negative correlation between sphericity and maximum diameter (r = -0.730, P<0.001). Sphericity was significantly lower in the >3cm group compared to the ≤3cm group (P<0.001). ［Conclusion］The detection rate of anterior mediastinal masses in this urban cancer screening cohort is lower than that reported in international studies, potentially attributable to the pre-selected high-risk nature of the screened population. Integrating unenhanced CT features with radiomic parameters facilitates the development of stratified follow-up strategies and helps avoid overtreatment. |
