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The purpose of this study was to compare the interobserver agreements and diagnostic accuracies for IASLC/ITMIG (International Association for the Study of Lung Cancer/International Thymic Malignancies Interest Group) thymic epithelial tumor staging of co-registered fluorodeoxyglucose positron emission tomography/magnetic resonance imaging (FDG-PET/MRI), MRI, integrated fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT), and conventional imaging examination.Prospective whole-body MRI including diffusion-weighted imaging, integrated PET/CTs, conventional imaging examinations, pathological examinations, and surgical reports, as well as follow-up examinations, were performed for 64 consecutive patients with thymic epithelial tumor. All FDG-PET/MRIs were co-registered PET data with MRI. TNM staging was evaluated by two radiologists on the basis of the IASLC/ITMIG thymic epithelial tumor staging system. Kappa statistics were determined for evaluations of agreements of all factors between each of the methods and final diagnosis. Finally, the diagnostic accuracy of each factor and of determination of the clinical stage was statistically compared to each other using McNemar test.Agreements for all factors between each method and final diagnosis were assessed as fair, moderate, substantial, or almost perfect (0.28 ≤ kappa value ≤ 0.80; P .0001). Diagnostic accuracy for N factor of PET/MRI (93.8% [60/64]) and MRI (93.8% [60/64]) was significantly higher than that of conventional imaging examination (81.3% [52/64] vs PET/MRI and MRI; P = .008). In addition, diagnostic accuracy for staging of PET/MRI (84.4% [54/64]) and MRI (84.4 [54/64]) was significantly higher than that of conventional imaging examination (71.9% [46/64] vs PET/MRI and MRI; P = .008).Whole-body PET/MRI, MRI, and PET/CT have better interobserver agreements and accuracies than conventional imaging examination for the new IASLC/ITMIG thymic epithelial tumor staging.

The centrosymmetric tetragonal itinerant magnet EuAl$_{4}$ exhibits an intricate magnetic phase diagram including rhombic and square skyrmion-lattice (SkL) phases in the external magnetic field. Here, we report a multi-axis dilatometric investigation of EuAl$_{4}$ by means of a newly designed fiber-Bragg-grating technique complemented by a resonant x-ray scattering experiment, revealing anisotropic magnetostriction and magnetovolume effect associated with successive phase transitions. The rhombic and square SkL phases are found to possess $\sim$0.10% and $\sim$0.03% orthorhombic structural distortion within the $ab$ plane, respectively. We propose that the coupling between the spin system and the lattice deformation should be essential for the structural instability in EuAl$_{4}$, yielding a rich variety of topological spin textures with spontaneous rotational-symmetry breaking as well as a potential controllability of the SkL phases by uniaxial stress or pressure., Comment: 8 pages, 5 figures, SM: 4 pages, 3 figures. To be published in Physical Review B as a Letter