Magnetic resonance imaging of the chest in the evaluation of cancer patients: state of the art

Abstract

Magnetic resonance imaging (MRI) has several advantages in the evaluation of cancer patients with thoracic lesions, including involvement of the chest wall, pleura, lungs, mediastinum, esophagus and heart. It is a quite useful tool in the diagnosis, staging, surgical planning, treatment response evaluation and follow-up of these patients. In the present review, the authors contextualize the relevance of MRI in the evaluation of thoracic lesions in cancer patients. Considering that MRI is a widely available method with high contrast and spatial resolution and without the risks associated with the use of ionizing radiation, its use combined with new techniques such as cine-MRI and functional methods such as perfusion- and diffusion-weighted imaging may be useful as an alternative tool with performance comparable or complementary to conventional radiological methods such as radiography, computed tomography and PET/CT imaging in the evaluation of patients with thoracic neoplasias.

Shear Wave Ultrasound Elastography and Diffusion-Weighted Magnetic Resonance Imaging Findings of Pleural-Based Masses with Histopathologic Correlation

“…Because of this feature, DWI is also used in the differential diagnosis of malignant and benign diseases. Its clinical uses include evaluation of pulmonary nodules, characterization of lung tumors, differentiation of post obstructive pneumoniatumor, evaluation of response after chemotherapy, evaluation of mediastinal lymph nodes and masses, and evaluation of pleural diseases (7,8,(23)(24)(25). A standard ROI (region of interest) measurement area or number has not been reported for ADC measurement from lesions.…”

ACR Appropriateness Criteria® Imaging of Mediastinal Masses

“…As a supplement to static assessment of tissue plane transgression, which can be difficult, dynamic CT [44] during free-breathing or cinematic cardiac gating can be performed to assess movement of the mass relative to adjacent structures and to confirm or exclude adherence of the mass to adjacent structures; however, dynamic MRI during free-breathing can accomplish the same task [45][46][47][48]. MRI remains superior to CT for detection of invasion of the mass across tissue planes, including the chest wall and diaphragm, and involvement of neurovascular structures, secondary to its higher soft tissue contrast [49][50][51][52].…”

“…Cross-sectional imaging by MRI remains superior to CT for detection of invasion of the mass across tissue planes, including the chest wall and diaphragm, and involvement of neurovascular structures, secondary to its higher soft tissue contrast [48][49][50][51][52]. As a supplement to static assessment of tissue plane transgression, dynamic MRI [45][46][47][48] during freebreathing or cinematic cardiac gating can be performed to assess movement of the mass relative to adjacent structures, to confirm or exclude adherence of the mass to adjacent structures, and to observe diaphragmatic motion in real time [80][81][82][83][84]; paradoxical motion or lack of motion can indicate phrenic nerve involvement by the mediastinal mass, without the need to perform a subsequent fluoroscopic sniff test.…”

Infectious and Non-Infectious Diseases Causing the Air Crescent Sign: A State-of-the-Art Review

“…A growing bulky tumor outstrips its blood supply and central ischemia leads to necrosis. When communication with an adjacent bronchus permits expectoration of the material, a cavity results [7,[44][45][46].…”