Pancoast tumors are non-small cell carcinomas that arise from the lung apex and invade the thoracic inlet. MRI is often used to examine the contiguous tumor progression in the superior sulcus towards the brachial plexus, vertebral bodies, intervertebral foramina, intraspinal space, and subclavian vessels.

Fat suppression images and contrast can be use to distinguish tumor from normal tissue. Note that following chemoradiation, there may still be remaining enhancing tissue but this is usually only reactive fibrous tissue without viable tumor cells.

Case courtesy of A/Prof Pramit Phal.