Click on image to view larger version.
FIGURE 1. Detection of unexpected malignant involvement of lymph nodes at initial staging. Patient with locally advanced nasopharyngeal cancer was referred for initial staging evaluation. Contrast-enhanced CT (A) and MRI (B) revealed 2 lymph nodes that were within normal limits by size criteria and for which the presence of malignant disease was uncertain (red arrows). (C) These 2 nodes clearly had abnormal activity on 18F-FDG PET/CT (yellow arrows), and radiation treatment field was adjusted to accommodate these regions.
