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Metastatic brachial plexopathy from breast cancer detected by 18F-FDG PET/MRI
Plexopatia braquial metastásica de un cáncer de mama detectada por 18F-FDG PET/MRI
G. Treglia
, G. Paone, L. Ceriani, L. Giovanella
Corresponding author
Department of Nuclear Medicine and PET/CT Centre, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
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PET/enhanced-contrast CT. Axial CT and fusion PET/CT images. Multiple hepatic lesions showing peripheral contrast and of <span class="elsevierStyleSup">18</span>F-FDG uptake, and hypodense, hypoactive center of fibrosis/necrosis compatible with metastatic lesions.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.R. García, E. Franquet, N. Romera, M. Moragas, S. Jorcano, G. Moragas" "autores" => array:6 [ 0 => array:2 [ "nombre" => "J.R." "apellidos" => "García" ] 1 => array:2 [ "nombre" => "E." "apellidos" => "Franquet" ] 2 => array:2 [ "nombre" => "N." "apellidos" => "Romera" ] 3 => array:2 [ "nombre" => "M." "apellidos" => "Moragas" ] 4 => array:2 [ "nombre" => "S." "apellidos" => "Jorcano" ] 5 => array:2 [ "nombre" => "G." 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Treglia, G. Paone, L. Ceriani, L. Giovanella" "autores" => array:4 [ 0 => array:4 [ "nombre" => "G." "apellidos" => "Treglia" "email" => array:1 [ 0 => "giorgiomednuc@libero.it" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "G." "apellidos" => "Paone" ] 2 => array:2 [ "nombre" => "L." "apellidos" => "Ceriani" ] 3 => array:2 [ "nombre" => "L." "apellidos" => "Giovanella" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Department of Nuclear Medicine and PET/CT Centre, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Plexopatia braquial metastásica de un cáncer de mama detectada por <span class="elsevierStyleSup">18</span>F-FDG PET/MRI" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1397 "Ancho" => 2501 "Tamanyo" => 266083 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Whole body maximum intensity projection (A) and coronal <span class="elsevierStyleSup">18</span>F-FDG PET (B and C), T1-weighted MRI (D and E) and fused <span class="elsevierStyleSup">18</span>F-FDG PET/MRI (F and G) images showing areas of abnormal <span class="elsevierStyleSup">18</span>F-FDG uptake corresponding to a thickening of the left brachial plexus (arrows). Histology demonstrated the presence of metastatic plexopathy from breast cancer.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 62-year-old woman with history of ductal-invasive carcinoma of the left breast, treated with surgery (left mastectomy and left axillary lymphadenectomy) and adjuvant chemotherapy and radiotherapy 17 years before, underwent imaging for restaging due to increased serum tumor markers levels (CEA and CA 15-3) and onset of pain on the left arm.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Whole-body computed tomography (CT) and other conventional imaging methods were negative. The patient even underwent a fused <span class="elsevierStyleSup">18</span>F-FDG PET/MRI which showed some areas of increased <span class="elsevierStyleSup">18</span>F-FDG uptake corresponding to an abnormal thickening of the left brachial plexus at MRI. No other areas of abnormal <span class="elsevierStyleSup">18</span>F-FDG uptake were evident in the rest of the body (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Based on these <span class="elsevierStyleSup">18</span>F-FDG PET/MRI findings, the patient underwent histology which demonstrated the presence of a metastatic plexopathy from breast cancer and she was addressed to chemotherapy.</p><p id="par0020" class="elsevierStylePara elsevierViewall">PET/MRI is of special interest for neuroscience, given that PET and MRI are the neuroimaging methods of choice for many clinical and scientific applications. The first clinical studies conducted have tested the performance of PET/MRI in oncology indications, neurodegenerative disorders and epilepsy, using different PET tracers.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The case which we have briefly presented illustrated the usefulness of fused <span class="elsevierStyleSup">18</span>F-FDG PET/MRI in evaluating neoplastic processes involving the peripheral nerves.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> This emerging technique combining metabolic and morphologic information has been very useful in the metabolic characterization and detection of a metastatic lesion of the brachial plexus. Further studies using <span class="elsevierStyleSup">18</span>F-FDG PET/MRI in this setting are expected in the next years.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interest</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflict of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2013-06-11" "fechaAceptado" => "2013-06-21" "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1397 "Ancho" => 2501 "Tamanyo" => 266083 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Whole body maximum intensity projection (A) and coronal <span class="elsevierStyleSup">18</span>F-FDG PET (B and C), T1-weighted MRI (D and E) and fused <span class="elsevierStyleSup">18</span>F-FDG PET/MRI (F and G) images showing areas of abnormal <span class="elsevierStyleSup">18</span>F-FDG uptake corresponding to a thickening of the left brachial plexus (arrows). Histology demonstrated the presence of metastatic plexopathy from breast cancer.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "PET/MRI: a new era in multimodality molecular imaging" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "O. Ratib" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Clin Transl Imaging" "fecha" => "2013" "volumen" => "1" "paginaInicial" => "5" "paginaFinal" => "10" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Molecular neuroimaging with PET/MRI" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "V. Garibotto" 1 => "S. Förster" 2 => "S. Haller" 3 => "M.I. Vargas" 4 => "A. Drzezga" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Clin Transl Imaging" "fecha" => "2013" "volumen" => "1" "paginaInicial" => "53" "paginaFinal" => "63" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Peripheral nerves, tumors, and hybrid PET-MRI" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.I. Vargas" 1 => "V. Garibotto" 2 => "M. Viallon" 3 => "R. Guignard" 4 => "V. Cuvinciuc" 5 => "K. Lovblad" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/RLU.0b013e31824c6013" "Revista" => array:6 [ "tituloSerie" => "Clin Nucl Med" "fecha" => "2013" "volumen" => "38" "paginaInicial" => "e40" "paginaFinal" => "e42" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23242064" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22538089/0000003300000001/v1_201402040008/S2253808913001560/v1_201402040008/en/main.assets" "Apartado" => array:4 [ "identificador" => "7927" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Interesting images" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22538089/0000003300000001/v1_201402040008/S2253808913001560/v1_201402040008/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808913001560?idApp=UINPBA00004N" ]
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