PET, CT, and MRI with Combidex for mediastinal staging in non-small cell lung carcinoma Kemp H Kernstine, MD, PhD, William Stanford, MD, Brian F Mullan,

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PET, CT, and MRI with Combidex for mediastinal staging in non-small cell lung carcinoma Kemp H Kernstine, MD, PhD, William Stanford, MD, Brian F Mullan, MD, Nicholas P Rossi, MD, Brad H Thompson, MD, David L Bushnell, MD, Kelley A McLaughlin, RN, Jeffrey A Kern, MD The Annals of Thoracic Surgery Volume 68, Issue 3, Pages 1022-1028 (September 1999) DOI: 10.1016/S0003-4975(99)00788-2

Fig 1 Demonstration of mediastinal adenopathy by PET and CT. The top two images show the primary lung mass using lung and mediastinal CT windows. The three PET images on the left show uptake of 18 FDG in the primary mass (top), anterior mediastinal lymph nodes (middle), and left hilar and subcarinal nodes (bottom). The images on the right are the corresponding CT images. The Annals of Thoracic Surgery 1999 68, 1022-1028DOI: (10.1016/S0003-4975(99)00788-2)

Fig 2 Demonstration of MLN metastasis by CT as compared with MRI-C. (A, B) Two separate levels of a CT scan performed on a single patient. There are three lymph nodes present, two in the right paratracheal area (A, arrows), and a third in the left hilar/paratracheal area (B, arrow). (CD) MR images at the transverse level, as in Figure 2A. (C) A pre-MRI-C T2-weighted image demonstrating the nodes seen in Figure 2A (4R nodes). In comparison, Figure 2D is the post-MRI-C T2-weighted image demonstrating the same nodes and showing a decrease in signal on this post-dose T2-weighted image indicating that these nodes are benign. (E, F) Images at similar MRI transverse thoracic level as seen on the CT in Figure 2B. (E) A pre-MRI-C T1 image demonstrating the suspicious node. Comparing it to the post-MRI-C T1-weighted image, Figure 2F shows no change. This node would be considered malignant. The Annals of Thoracic Surgery 1999 68, 1022-1028DOI: (10.1016/S0003-4975(99)00788-2)