HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Abstract Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hathaway, P. B. Articles by Moe, R. E. Search for Related Content PubMed PubMed Citation Articles by Hathaway, P. B. Articles by Moe, R. E.

Value of Combined FDG PET and MR Imaging in the Evaluation of Suspected Recurrent Local-Regional Breast Cancer: Preliminary Experience

¹ Departments of Radiology (P.B.H., D.A.M., K.R.M., A.A.C., C.E.H.)
² Radiation Oncology (M.M.A.S.)
³ Division of Medical Oncology (G.K.E., J.R.G.)
⁴ Department of Surgery (R.E.M.), University of Washington School of Medicine, Box 356113, Room NN203, 1959 NE Pacific St, Seattle, WA 98195-7115.

View larger version (131K): [in a new window]   Figure 1a. Patient 5. (a) Oblique sagittal T1-weighted SE MR image (650/16) shows a mass (curved arrows) within the pectoralis major muscle that involves the chest wall; axillary artery (arrowhead), axillary vein (open arrow), and brachial plexus (straight solid arrow) are seen. (b) Coronal FDG PET image shows intense uptake of tracer in the right axilla. Areas of high FDG uptake appear dark in the image. Uptake is seen in the main tumor mass (arrow) and satellite lesions (arrowheads), which likely represent nodes. (c) Coronal T1-weighted SE MR image (600/10) shows no evidence of neurovascular invasion; axillary artery (arrows) and brachial plexus (arrowheads) are seen. Imaging findings were confirmed at surgery.

View larger version (136K): [in a new window]   Figure 1c. Patient 5. (a) Oblique sagittal T1-weighted SE MR image (650/16) shows a mass (curved arrows) within the pectoralis major muscle that involves the chest wall; axillary artery (arrowhead), axillary vein (open arrow), and brachial plexus (straight solid arrow) are seen. (b) Coronal FDG PET image shows intense uptake of tracer in the right axilla. Areas of high FDG uptake appear dark in the image. Uptake is seen in the main tumor mass (arrow) and satellite lesions (arrowheads), which likely represent nodes. (c) Coronal T1-weighted SE MR image (600/10) shows no evidence of neurovascular invasion; axillary artery (arrows) and brachial plexus (arrowheads) are seen. Imaging findings were confirmed at surgery.

View larger version (67K): [in a new window]   Figure 1b. Patient 5. (a) Oblique sagittal T1-weighted SE MR image (650/16) shows a mass (curved arrows) within the pectoralis major muscle that involves the chest wall; axillary artery (arrowhead), axillary vein (open arrow), and brachial plexus (straight solid arrow) are seen. (b) Coronal FDG PET image shows intense uptake of tracer in the right axilla. Areas of high FDG uptake appear dark in the image. Uptake is seen in the main tumor mass (arrow) and satellite lesions (arrowheads), which likely represent nodes. (c) Coronal T1-weighted SE MR image (600/10) shows no evidence of neurovascular invasion; axillary artery (arrows) and brachial plexus (arrowheads) are seen. Imaging findings were confirmed at surgery.

View larger version (197K): [in a new window]   Figure 2a. Patient 1. (a) Coronal contrast medium–enhanced T1-weighted SE image (700/10; fat saturation) and (b) coronal STIR MR image (4,000/43/160) of the left shoulder region show diffuse thickening, increased signal intensity, and contrast enhancement of the medial and lateral cords of the brachial plexus (arrows). (c, d) FDG PET images of two different coronal planes show abnormal linear tracer uptake in the left axilla (arrowheads in c) and unsuspected metastatic tumor within a left cervical lymph node (arrow in d). FDG was injected through a right-sided central venous catheter. Correlation between MR and FDG PET images resulted in a final diagnosis of brachial plexus invasion by metastatic tumor. Surgery was deferred because of the imaging findings.

View larger version (189K): [in a new window]   Figure 2b. Patient 1. (a) Coronal contrast medium–enhanced T1-weighted SE image (700/10; fat saturation) and (b) coronal STIR MR image (4,000/43/160) of the left shoulder region show diffuse thickening, increased signal intensity, and contrast enhancement of the medial and lateral cords of the brachial plexus (arrows). (c, d) FDG PET images of two different coronal planes show abnormal linear tracer uptake in the left axilla (arrowheads in c) and unsuspected metastatic tumor within a left cervical lymph node (arrow in d). FDG was injected through a right-sided central venous catheter. Correlation between MR and FDG PET images resulted in a final diagnosis of brachial plexus invasion by metastatic tumor. Surgery was deferred because of the imaging findings.

View larger version (63K): [in a new window]   Figure 2c. Patient 1. (a) Coronal contrast medium–enhanced T1-weighted SE image (700/10; fat saturation) and (b) coronal STIR MR image (4,000/43/160) of the left shoulder region show diffuse thickening, increased signal intensity, and contrast enhancement of the medial and lateral cords of the brachial plexus (arrows). (c, d) FDG PET images of two different coronal planes show abnormal linear tracer uptake in the left axilla (arrowheads in c) and unsuspected metastatic tumor within a left cervical lymph node (arrow in d). FDG was injected through a right-sided central venous catheter. Correlation between MR and FDG PET images resulted in a final diagnosis of brachial plexus invasion by metastatic tumor. Surgery was deferred because of the imaging findings.

View larger version (66K): [in a new window]   Figure 2d. Patient 1. (a) Coronal contrast medium–enhanced T1-weighted SE image (700/10; fat saturation) and (b) coronal STIR MR image (4,000/43/160) of the left shoulder region show diffuse thickening, increased signal intensity, and contrast enhancement of the medial and lateral cords of the brachial plexus (arrows). (c, d) FDG PET images of two different coronal planes show abnormal linear tracer uptake in the left axilla (arrowheads in c) and unsuspected metastatic tumor within a left cervical lymph node (arrow in d). FDG was injected through a right-sided central venous catheter. Correlation between MR and FDG PET images resulted in a final diagnosis of brachial plexus invasion by metastatic tumor. Surgery was deferred because of the imaging findings.

View larger version (163K): [in a new window]   Figure 3a. Patient 2. (a) Coronal T1-weighted SE MR image (600/10) shows nonspecific intermediate-intensity soft tissue (arrowheads) in the left axilla; other MR images revealed axillary vein encasement (not shown), but no evidence of brachial plexus invasion was seen. (b) Coronal FDG PET image shows intense uptake in the left axillary region (arrow). Recurrent tumor was confirmed at surgery, but unexpected invasion of the brachial plexus and axillary artery prevented complete resection.

View larger version (67K): [in a new window]   Figure 3b. Patient 2. (a) Coronal T1-weighted SE MR image (600/10) shows nonspecific intermediate-intensity soft tissue (arrowheads) in the left axilla; other MR images revealed axillary vein encasement (not shown), but no evidence of brachial plexus invasion was seen. (b) Coronal FDG PET image shows intense uptake in the left axillary region (arrow). Recurrent tumor was confirmed at surgery, but unexpected invasion of the brachial plexus and axillary artery prevented complete resection.