Value of combined FDG PET and MR imaging in the evaluation of suspected recurrent local-regional breast cancer: preliminary experience.
OBJECTIVE
To assess the performance and potential clinical effects of combined 2-[fluorine 18]fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) and magnetic resonance (MR) imaging of the axilla and brachial plexus in patients suspected of having local-regional breast cancer metastases.


METHODS
Upper-body FDG PET and axillary and supraclavicular MR imaging were performed in 10 patients (age range, 45-71 years) with clinical findings suggestive of breast cancer metastases. Medical records were reviewed retrospectively. Imaging findings were correlated with clinical data and follow-up findings in all patients. Surgical findings were available in four patients.


RESULTS
Nine patients had local-regional breast cancer metastases. MR imaging was diagnostic for tumor in five patients and was indeterminate in four patients with axillary or chest wall metastases. With FDG PET, metastatic tumor was positively identified in all nine patients. MR imaging was useful for determining the relationship of metastatic tumor to axillary and supraclavicular neurovascular structures. FDG PET helped confirm metastases in patients with indeterminate MR imaging findings and depicted unsuspected metastases outside the axilla.


CONCLUSIONS
MR imaging and FDG PET are complementary in detecting and characterizing local-regional breast cancer metastases. Combined FDG PET and MR imaging provide useful treatment-planning data for patients clinically suspected of having recurrent axillary or supraclavicular breast cancer.
Hathaway
P B
PB
Department of Radiology, University of Washington School of Medicine, Seattle 98195-7115, USA.
Mankoff
D A
DA
Maravilla
K R
KR
Austin-Seymour
M M
MM
Ellis
G K
GK
Gralow
J R
JR
Cortese
A A
AA
Hayes
C E
CE
Moe
R E
RE
D000368:Aged; D001365:Axilla / Q000000981:diagnostic imaging / Q000473:pathology; D001917:Brachial Plexus / Q000000981:diagnostic imaging / Q000473:pathology; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002968:Clavicle / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D015411:Mastectomy, Modified Radical; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000000981:diagnostic imaging; D009367:Neoplasm Staging; D010347:Patient Care Planning; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology; D019275:Radiopharmaceuticals; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D013899:Thoracic Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000556:secondary; D014055:Tomography, Emission-Computed
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18