Accuracy of computed tomography perfusion in assessing metastatic involvement of enlarged axillary lymph nodes in patients with breast cancer

Abstract

Introduction The purpose of this study was to evaluate the diagnostic accuracy of computed tomography (CT) perfusion in differentiating metastatic from inflammatory enlarged axillary lymph nodes in patients with breast cancer.

Does volume perfusion computed tomography enable differentiation of metastatic and non-metastatic mediastinal lymph nodes in lung cancer patients? A feasibility study

“…Our results for lung cancer metastasis to the mediastinum differ from those reported for oropharyngeal/hypopharyngeal cancer metastasis to the neck [ 31 ] or breast cancer metastasis to the axilla [ 32 ] , where higher perfusion values are described in metastatic compared with normal lymph nodes. There are different possible explanations for this diversity, as well as the great overlap in perfusion of both metastatic and non-metastatic lymph nodes.…”

“…Furthermore, lung cancer and mediastinal metastatic disease are often diagnosed at a later stage and with larger tumor volumes than oropharyngeal cancer and neck metastasis or breast cancer and axillary metastasis. This is also reflected in our results where we find a mean tumor volume of mediastinal metastases of 26.4 ± 28.9 ml, which is much larger than the neck metastases of oropharyngeal cancer (5.19 ± 4.89 ml) described by Bisdas et al [ 31 ] or the axillary metastases (mean diameter 1.60 ml) observed by Liu et al [ 32 ] . As larger tumors have a higher likelihood of becoming necrotic [ 19 , 33 ] , this may at least partially explain the differences in perfusion traits.…”

“…In contrast, Bisdas et al [ 31 ] observed that perfusion values and permeability surface product as determined by VPCT were not significantly different in metastatic and non-metastatic lymph nodes in patients with oropharyngeal and oral cavity cancer. Liu et al [ 32 ] again found significant differences in BF (but not BV or permeability surface) via VPCT between metastatic and inflammatory enlarged axillary lymph nodes in patients with breast cancer. Hence, additional characteristics, such as vascularization and permeability of lymph nodes, may enable a further improvement in the diagnosis of lymph node metastasis.…”

“…Non-metastatic mediastinal lymph node enlargement is believed to represent a reaction to infectious or immunologic processes passing through different phases of inflammatory activity. Thus, the coexistence of both active and inactive inflammation within these nodes may have a bearing on the degree of perfusion [ 32 , 35 ] . Moreover, areas of post-stenotic pneumonia and impairment of mucociliary clearance are accompanied by some degree of inflammation, which may again affect lymph node perfusion.…”

Imaging of Tumor Angiogenesis: Functional or Targeted?

“…Accuracy of computed tomography perfusion in assessing metastatic involvement of enlarged axillary lymph nodes in patients with breast cancer. Breast Cancer Res 2007; 9:R40 [80])…”