Value of combined FDG PET and MR imaging in the evaluation of suspected recurrent local-regional breast cancer: Preliminary experience

PURPOSE: To assess the performance and potential clinical effects of combin ed 2-[fluorine 18]fluoro-2-deoxy-D-glucose (FDG) positron emission tomograp hy (PET) and magnetic resonance (MR) imaging of the axilla and brachial ple xus in patients suspected of having local-regional breast cancer metastases . MATERIALS AND METHODS: Upper-body FDG PET and axillary and supraclavicular MR imaging were performed in 10 patients (age range, 45-71 years) with clin ical findings suggestive of breast cancer metastases, Medical records were reviewed retrospectively. Imaging findings were correlated with clinical da ta and follow-up findings in all patients. Surgical findings were available in four patients. RESULTS: Nine patients had local-regional breast cancer metastases. MR imag ing 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 supra clavicular neurovascular structures. FDG PET helped confirm metastases in p atients with indeterminate MR imaging findings and depicted unsuspected met astases outside the axilla. CONCLUSION: MR imaging and FDG PET are complementary in detecting and chara cterizing local-regional breast cancer metastases. Combined FDG PET and MR imaging provide useful treatment-planning data for patients clinically susp ected of having recurrent axillary or supraclavicular breast cancer.