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The whole-body positron emission tomography (PET)/magnetic resonance (MR) scan is a cutting edge technology providing comprehensive structural information from MR imaging and functional features from PET in a single session. Recent research findings and clinical experience have shown that ¹⁸F-fluorodeoxyglucose (FDG) whole-body PET/MRimaging has a diagnostic performance comparable with or superior to that of PET/CT in the field of oncology, including for breast cancer. In particular, FDG PET/MR mammography in the prone position with the breast hanging in a pendant manner can provide more comprehensive information about the metabolism, anatomy, and functional features of a breast lesion than a whole-body PET/MR scan. This article reports on current state-of-the-art PET/MR mammography in patients with breast cancer and the prospects for potential application in the future.
Subject(s)
Humans , Breast Neoplasms , Breast , Electrons , Magnetic Resonance Imaging , Mammography , Metabolism , Positron-Emission Tomography , Positron Emission Tomography Computed Tomography , Prone PositionABSTRACT
Objective To discuss the MSCT imaging characteristics of metastatic lymph nodes in pancreatic cancer.Methods The MSCT images of 30 pancreatic cancer patients with metastatic lymph node confirmed by pathology were selected and all the patients underwent enhanced MSCT before surgery.The location, maximum short axis diameter ( MSAD) , sizes, density, enhancement, necrosis and fusion of the metastatic lymph nodes were analyzed using the 5th edition of TNM stage of Japan Pancreatic Society in 2002 as the standard.Results Sixty-three metastatic lymph nodes was pathologically diagnosed , while 53were diagnosed by MSCT.The metastatic lymph nodes most commonly occurred in group 13 and 17in pancreatic head cancer, while group 18 lymph node metastasis was more common in pancreatic body and tail cancer.The MSAD of metastatic lymph nodes was 2~17 mm with the average of (7.2 ±4.0)mm.All of metastatic lymph nodes were divided into MSAD <5 mm group, 5 mm~<10 mm group and ≥10 mm group based on their size.The number of metastatic lymph nodes of the three groups were 10, 18 and 25, respectively.The number of enhanced metastatic lymph nodes was decreased as the size increased, while the number of necrotic and fused lymph nodes was increased, which were statistically different (all P<0.05).Comparison between the two groups showed that the number of enhancement metastatic lymph nodes in MSAD <5 mm group and 5 mm~<10 mm group were more than that in ≥10 mm group ( 7/10 and 11/18 vs 2/25 ) .The number of fused lymph nodes in MSAD <5 mm group and 5 mm~<10 mm group were less than that in≥10 mm group (0 and 2/18 vs 22/25 ) .Clear edge metastatic lymph nodes were more in MSAD <5 mm group than that in≥10 mm group (6/10 vs 5/25).The number of necrotic metastatic lymph nodes in MSAD <5 mm group was less than that in ≥10 mm group(2 /10 vs 18/25).All the differences above were statistically significant ( all P<0.05), but no other significant differences were found between two groups.Conclusions The main imaging findings of metastatic lymph nodes in pancreatic cancer were unobvious enhancement, intratumoral necrosis and fusion.Heterogeneous density and unclear edge could benefit the diagnosis of metastatic lymph node.
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Objective To study the metastasis frequencies and areas of solitary bronchioloalveolar carcinoma (BAC) of different diameters, so as to guide the intraoperative lymph node dissection. Methods A total of 137 patients with pathologically-confirmed solitary BAC received surgical treatment. The patients were divided into 3 groups according to tumor diameters: ≤2 cm group,2-3 cm group,and >3 cm group. The N1 and N2 lymph node metastasis rates of the 3 groups were analyzed. Results The N1 lymph node metastasis rates were significantly different between the 3 groups (P<0. 05); for tumors with greater diameter, the tenth group lymph nodes should be completely dissected. The N2 lymph node metastasis rates were not significantly between the 3 groups (P<0. 05). Conclusion The tumor diameter of BAC may be used to guide the dissection extent of N1 group lymph nodes, but not that of N2 group lymph nodes.
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Objective To study the metastasis frequencies and areas of solitary bronchioloalveolar carcinoma (BAC) of different diameters, so as to guide the intraoperative lymph node dissection. Methods A total of 137 patients with pathologically-confirmed solitary BAC received surgical treatment. The patients were divided into 3 groups according to tumor diameters: ≤2 cm group,2-3 cm group,and >3 cm group. The N1 and N2 lymph node metastasis rates of the 3 groups were analyzed. Results The N1 lymph node metastasis rates were significantly different between the 3 groups (P<0. 05); for tumors with greater diameter, the tenth group lymph nodes should be completely dissected. The N2 lymph node metastasis rates were not significantly between the 3 groups (P<0. 05). Conclusion The tumor diameter of BAC may be used to guide the dissection extent of N1 group lymph nodes, but not that of N2 group lymph nodes.
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Objective To compare number and level of positive lymph nodes (PLNs) to see which is a better predictor of prognosis for node-pesitive colon cancer. Methods Seventy-eight patients had undergone curative resection for node-positive colon cancer. Calculated the cumulative 3-year, 5-year survival rates and explored the relation to survival rates between number (pN1/pN2) and level (level Ⅰ/Ⅱ)of PLNs. Results The 3-year, 5-yesr survival rotes of colon cancer with PLNs was 73.1%(57/78), 65.4%(51/78). There was statistical difference of 3-year, 5-year survival rates between pN1 group and pN2 group [77.8% (42/54)vs 62.5% (15/24), 72.2% (39/54)vs 50.0% (12/24),P =0.004], but no statistical difference between level Ⅰ group and level Ⅱ group [77.5 %(31/40) vs 68.4%(26/38), 67.5%(27/40) vs 63.2% (24/38),P=0.349]. Conclusion In node-positive colon cancer, number of PLNs predicts prognosis better than level of PLNs.
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Objective:To assess the potential or limitation of MRI for demontrating the pathological cervicallymphnodes. Method :A prospective diagnostic study on cervical lymphnode metastasis from laryngeal carcinomawas performed for 19 cases undergone neck dissection (5 cases undergone bilateral neck dissection, 24 specimensof neck dissection were collected in total). With pathological findings as the criterion, sensitivity and specificityand accuracy were calculated for palpation and MRI examination of all patients. Result:MRI had obviously highersensitivity specificity and accuracy than palpation. Besides the changes in size and shape of the metastaticlymphnodes, the intensity of MRI inside the metastic lymphnodes was showed as mixed hypo-isointensity inT1WI and hyper intensity in T2WI. Conclusion:MRI examination was accurate in detecting cervical lymphnodemetastasis and could image occult lymphnodes which are inaccessible on palpation. Thus, MRI will probably playan important role in the evaluation of malignant lymphnode metastasis.