Preoperative evaluation of bronchogenic carcinoma: value of MR in T- and N-staging

Seventy consecutive patients with a bronchogenic carcinoma, in whom chest radiographs did not allow a sufficient evaluation of primary tumor localization or extension were examined by MR (1T). All diagnoses were confirmed by operation and histopathologic examination (Stage T1: 6 patients, Stage T2: 36 patients, Stage T3: 19 patients, Stage T4: 9 patients). T-staging was correct in 79% of patients. Significant infiltration of major bronchi, of the pericardium, heart, mediastinal fat and chest wall can be visualized with a reasonable degree of accuracy. N-staging based on lymph-node size was correct in 56%. A correlation between lymph-node size and metastatic involvement was not found. MR is limited by the spatial resolution, by the lack of tissue specificity and by artifacts. MR is a useful diagnostic tool in the evaluation of the primary tumor extension, however, especially in borderline cases histopathologic examination is required. A reliable N-staging is not possible based on lymph-node size measurement.