By Giampiero Ausili Cefaro, Carlos A. Perez, Domenico Genovesi, Annamaria Vinciguerra
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"This is a concise advisor to radiological definitions of lymph node teams for radiation therapy making plans. … the first viewers is radiation oncologists in any respect phases in their careers. citizens and scholars should still locate this a truly necessary anatomical consultant. The authors are popular in radiation oncology and/or radiology. … this can be a beneficial advisor for the lymph node anatomy of the foremost illness web site regions." (James G. Douglas, Doody’s evaluation provider, July, 2009)
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Additional info for A Guide for Delineation of Lymph Nodal Clinical Target Volume in Radiation Therapy
A Medial edge of Symphysis menti, ant. belly of digas- platysma m. tric m. , cranial edge of submandibular gland Plane through central part of hyoid bone Lateral edge of Basilar edge/inner ant. belly of digas- side of mandible, tric m. , skin Symphysis menti, platysma m. IIa Caudal edge of lateral process of C1 Caudal edge of the body of hyoid bone Medial edge of Medial edge of int. carotid artery, sternocleidomasparaspinal (levator toid m. scapulae) m. Post. edge of Post. border of submandibular int.
For studying the upper abdominal region, the recommended window level is 40 HU while window width is 350–400 HU. •• Pelvis. For soft tissues a width of 400 HU and a level of 40 HU are recommended. For bones, recommended values are the same as for the head and neck region. 1 – (continued) Parameters for performing the planning CT Pelvisb Algorithm Soft/standard Matrix 1,024 × 1,024 pixel FOV Adapted to the patient and sized to include the patient’s contour a For possible optimization of the CT acquisition method, the parameters for this region may be changed as follows: slice thickness 3 mm, table speed/rotation 3 mm/s, reconstruction interval 3 mm b For possible optimization of the CT acquisition method, the parameters for this region may be changed as follows: slice thickness 5 mm, table speed/rotation 8 mm/s, reconstruction interval 4 mm 42 S ec t io n II Target Volume Delineation in Modern Radiation Therapy 5 Critical Importance of Target Definition, Including Lymph Nodes, in Image-Guided Radiation Therapy * Exciting advances have taken place in oncology, including enhanced knowledge of molecular biology and genetics, functional imaging (positron emission tomography scanning), image-guided radiation therapy and robotic surgery, increased use of monoclonal antibodies, as well as molecular targeted cytotoxic agents, which are increasingly applied to clinical situations.
5-cm margin medial to the iliopsoas muscle starting from intervertebral space S2–S3 and continuing until the vascular expansion volume is visualized, to include the lateral external iliac lymph nodes. 7-cm margin medial to the pelvic wall, starting 1 cm above intervertebral space S2–S3 and continuing inferior to the inguinal nodes, to include the obturator nodes (or medial external iliac nodes). •• Exclusion of bones and air. 5 cm ventrally with respect to the aorta and the common iliac arteries.
A Guide for Delineation of Lymph Nodal Clinical Target Volume in Radiation Therapy by Giampiero Ausili Cefaro, Carlos A. Perez, Domenico Genovesi, Annamaria Vinciguerra