Imaging of axillary lymph nodes

There is increasing interest in the radiological diagnosis of axillary lymp h nodes in patients with breast cancer, especially in the preoperative diag nosis of metastatic nodes. Both CT (computed tomography) and MRI (magnetic resonance imaging) are cross-sectional imaging methods that produce high-qu ality images of the axilla. MRI also uses contrast enhancement profile, for example in imaging of breast lesions. Few studies have been published on t his subject, but the latest have shown high sensitivity and specificity (CT 93.8 and 82.1%, respectively; MRI 90 and 82%, respectively), although, bot h CT and MRI are restricted to imaging only. US (ultrasound) is widely spre ad and is fast and accurate with high resolution. Sensitivity and specifici ty vary (68.2-92% and 90-100%, respectively). Most importantly, there is th e possibility of US-guided FNAB (fine-needle aspiration biopsy) of patholog ical nodes, which increases the specificity. Initial results with colour Do ppler are promising, but a recent study has shown that the presence of colo ur Doppler flow signal is highly non-specific. Other parameters such as flo w pattern and distribution may prove to be of value in this method. Today, the method of choice for the daily routine is US in conjunction with FNAB.