 Hello, everyone. My topic for the paper presentation is Pediatric Mediation, a case series in the tertiary care sector in Kostu, Karnataka. I'm Dr. Rimsha Afkan, a postgraduate resident studying in Father Muller's Medical College, Karnataka. So the aim of the study was to find out how efficiently and recently we can diagnose Pediatric and Mass patients using histopathology as the post-standard by calculating its sensitivity, specificity, positive predictive value, and negative predictive value. Mediastinal masses are a broad category of tumors that affect people of all ages and are notoriously difficult to diagnose. The mediation space is small and any masses that arise from there will compress the surrounding structures, resulting in life-threatening emergencies. So these can either be primary or secondary tumors and they can be congenital or acquired. Primary mediastinal tumors are uncommon, whereas secondary mediastinal tumors are more common and they are more likely to have lymphatic involvement from primary lung or infadiationatic organ tumors. A brief description of mediastinal anatomy is required to understand the various mediastinal masses and to decide on any diagnostic and therapeutic program. So the mediastinum is an anatomic region of the thorax that is bounded anteriorly by the sternum, posteriorly by the spine and laterally by the lungs and their prudent lining. So there are various classification systems used in clinical and radiological practice and this distinction in nomenclature between specialties causes a lot of confusion as a result to appropriately describe mediastinal abnormalities and formulate relevant differential diagnosis. A standardized classification based on MDCT is required. So the ITMIG, that is the International Thymic Malignancy Interest Group, has developed a new cross-sectional imaging-based mediastinal compartment classification system and this is modified from JARP, that is the Japanese Association, to research on the thymus. So this is the ITMIG scheme. The yellow area denotes the pre-vascular space. The pink area denotes the visceral space and the line drawn one centimeter behind the anterior border of the vertebral body, that is the blue area, denotes the paravertebran space. Coming to the materials and methods of study, this study analyzed patients retrospectively who had an MDCT scan done in the department of radiodiacosis at Fadamulo Medical Hospital to characterize a mediastinal mass over the course of one year. And the study included patients of all age groups who had a clinical suspicion of a mediastinal mass lesion and a chest radiograph with a suspicious mediastinal abnormality. The sample size was 80 and the institutional ethical committee provided ethical clearance prior to the start of the study. The inclusion criteria includes patients of both sexes of any age group with the clinical suspicion of a mediastinal mass lesion and chest radiograph showing mediastinal mass or widening and the report of the histopathological examination being available. The exclusion criteria includes patients who have not had an HPE report, patients who are allergic to IV contrast agents, patients who have a low GFR of less than 30, post-surgery patients, pregnant patients and lesions of vascular or cardiac origin. The scan was carried out on the Philips 128-slice CT system and a plain tomogram was used as a guide for the study. To keep the scan time short and reduce motion artifacts, the entire mediastinum was scanned with MD-CD in a catholocodal direction in a single breath code. Sequentially, un-enhanced and contrast-enhanced scans were performed. For contrast enhancement, injection of IOhexol, which is a non-ionic, non-iodon contrast agent, was given, multi-planar reconstruction and 3D volume rendering images were created and multiple window settings like the mediastinal window, the lung window and the bone window were utilized to evaluate the lesions. So, MD-CD characteristics of the mediastinal mass lesions and compartmentalization based on IT-MNG classification system was done and various characteristics were also included. All the cases were evaluated for compartment localization and MD-CD features of the mediastinal mass along with the involvement of the adjoining structures. All the patients underwent 3-procedure CT and anteroposterio and lateral-vue chest x-rays. Coming to the results of the study, in this study out of 80 cases, 57.5% were males and 42.5% were females. The age group ranged from 4 years to 85 years old and the most common age group to present with the mediastinal mass was between 60 to 70 years. The mean age was around 50 years. And the most common symptom which was presented with was breathlessness followed by cough. 11.25% of the cases were also asymptomatic. The most common compartment which was involved was the pre-vascular space which accounted for 66.25% followed by the paravertebral space which accounted for 22.5%. The pre-vascular space masses consisted mostly of the thymoma which accounted for 12.5% followed by metastatic lymphoidal masses which accounted for 11.25% So in this image, we can see a thymoma which is visible as a heterogeneous mass lesion in the pre-vascular space. Isophageal carcinoma was the most common kind which was found in the visceral compartment accounting for about 7.5% and the bulk of the posterior mediaspinal masses were caused by mutant tumors which made up 7.5%. So here in this image, we can see a large hypodense mass seen in the upper posterior mediasystem extending to the lower neck on the right side. Histology shows features of the schwannoma. According to the findings of the research, lymphoidal masses made up up to 17.5% of the total mediaspinal masses. The involvement of metastatic lymph nodes was the most common kind of this accounting for 11.25%. So these are the findings of multi-detector computed tomography as well as the conclusive histological diagnosis. And this is the percentage and frequency of the mediaspinal masses. The nine masses account for about 79.4% and malignant masses account for about 20.5%. Coming to the discussion, in this investigation, Disneya was shown to be the most typically presenting symptom and there was a correlation between histological examination and 23 benign cases and 38 malignant cases. But in 14 of the instances, the diagnosis based on CT did not correspond with the histological diagnosis. So here we can see that the sensitivity of the study was about 80.4%. The specificity was 79.4%. The positive predictive value was 80.4%. Negative predictive value being 79.4%. And the total accuracy of the study comes up to 82.5%. So conclusion, the diagnosis of a mediaspinal mass nation may frequently be determined with a high level of certainty based only on its location and the imaging findings. In other instances, a diagnosis may be provided when the radiologic characteristics and the particular clinical facts are taken together. It is possible to distinguish benign and malignant tumors with a high degree of precision. It might be difficult to distinguish between metastatic lymph nodes and tuberculous lymph nodes in patients who have grim enhancing lymph nodes. The MDCP is a time and money saving non-invasive technique that in order to properly diagnose and treat a mediaspinal mass patient must be utilized in conjunction with other imaging modalities such as bed and MRI whenever the circumstances will require. These are the references that I have used for my study.