A Guide for Delineation of Lymph Nodal Clinical Target by Giampiero Ausili Cefaro, Carlos A. Perez, Domenico Genovesi,

By Giampiero Ausili Cefaro, Carlos A. Perez, Domenico Genovesi, Annamaria Vinciguerra

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"This is a concise consultant to radiological definitions of lymph node teams for radiation remedy making plans. … the first viewers is radiation oncologists in any respect levels in their careers. citizens and scholars should still locate this a really worthy anatomical consultant. The authors are popular in radiation oncology and/or radiology. … this can be a priceless advisor for the lymph node anatomy of the main sickness website regions." (James G. Douglas, Doody’s evaluate carrier, July, 2009)

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Additional resources for A Guide for Delineation of Lymph Nodal Clinical Target Volume in Radiation Therapy

Sample text

In mediastinal irradiation, patients lie supine with both arms extended above the head. It is advisable to use personalized positioning and immobili- zation systems and controlled breathing procedures so as to minimize the geometrical uncertainty of the treatment (vacuum system, T-bar device, Perspex cast). , cast or vacuum system). Moreover, for better setup of treatment fields, the arms should be raised above the head. In some cases of radiation delivery to the pelvic region, the prone position may be considered as an alternative to the supine position.

2 illustrates the anatomicoradiological boundaries of mediastinal nodal stations up to station 8 based on our experience. To identify pulmonary ligament nodes (stations 9R and 9L), hilar nodes (stations 10R and 10L), and interlobar nodes (stations 11R and 11L) we have preferred a nonschematic description, provided here below: •• Pulmonary ligament lymph nodes (stations 9R and 9L) are paired lymph nodes, left and right, lying within the pulmonary ligaments. The region in which these nodes are located is difficult to identify on CT scan, since the pulmonary ligament itself is not always clearly visible.

Pelvis. The upper limit has been established 1 cm cranial to the upper limit of the iliac crests, while the lower limit is located at the level of the ischio­ rectal fossae or, in case of rectal cancer infiltrating the anal canal, or cancer of the anal canal, or of the vulva and vaginal canal, at the level of the anal verge. 1. The recommended window settings for best viewing of different tissues of the four anatomical regions are the following: •• Head-neck. The window width and window level of CT images for head-neck soft tissues are 350 Hounsfield units (HU) and 35 HU, respectively.

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