Bronchogenic carcinoma invasion of the chest wall: evaluation with dynamic cine MRI during breathing.

Abstract

Our goal was to assess the utility of breathing dynamic cine MR (BDCMR) in the evaluation of tumor invasion to the chest wall in bronchogenic carcinomas. BDCMR imaging was performed preoperatively in 25 patients with bronchogenic carcinomas adjacent to the chest wall. Twelve sequential images were obtained in the same coronal and/or sagittal planes during one respiratory cycle with fast spoiled GRASS sequence, and analysis with cine-loop display was performed. In all 14 cases in which free movement of tumor along the parietal pleura on BDCMR was demonstrated, no chest wall invasion was evident at thoracotomy. However, of 11 patients with fixation of the tumor on BDCMR, 5 had benign pleural adhesions, 5 had chest wall invasion at thoracotomy, and 1 with an apical tumor had no benign pleural adhesion or chest wall invasion. Although BDCMR cannot distinguish benign pleural adhesions from chest wall invasion by tumor, this method accurately estimated the free movement of lung tumors with no invasion of chest wall from bronchogenic carcinomas prior to surgery.