By Giampiero Ausili Cefaro, Carlos A. Perez, Domenico Genovesi, Annamaria Vinciguerra
From the reviews:
"This is a concise advisor 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 truly worthy anatomical advisor. The authors are popular in radiation oncology and/or radiology. … this can be a important advisor for the lymph node anatomy of the most important affliction website regions." (James G. Douglas, Doody’s overview carrier, July, 2009)
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Additional resources for A Guide for Delineation of Lymph Nodal Clinical Target Volume in Radiation Therapy
4 – Anatomicoradiological boundaries of pelvic region lymph nodes Lymph nodes Anatomical boundaries Cranial Caudal Common iliac nodes Bifurcation of abdominal aorta (at the inferior border of L4) Internal iliac nodes Bifurcation of common iliac vessels (at the inferior border of L5) Lateral Anterior Bifurcation of Loose cellular the common iliac tissue vessels (at the inferior border of L5, at the level of the superior border of the ala of sacrum) Psoas muscle Loose cellular Body of L5 tissue anterior to the common iliac vessels Plane through Loose cellular superior border tissue of the head of femurs at the level of the superior border of the coccyx Piriformis muscle Posterior border Loose cellular of the external tissue iliac lymph nodes and loose cellular tissue External iliac Bifurcation of nodes common iliac vessels (at the inferior border of L5) Femoral artery Loose cellular tissue Iliopsoas muscle Obturator nodes Plane through the acetabulum Superior border of the neck of femurs, at the small ischiadic foramen Loose cellular tissue Internal obturaLoose cellular tor muscle (intissue trapelvic portion) Loose cellular tissue Presacral nodes Intervertebral space of L5–S1 (sacral promontory) Superior border of the 1st coccygeal vertebra – Piriformis muscle Loose cellular tissue Anterior aspect of sacrum Inguinal nodes Superior limit of the neck of femurs Bifurcation of the Adductor femoral artery muscles into its superficial and deep branches For superficial Subcutaneous inguinal nodes: adipose tissue the adipose and loose connective tissue and the sartorius muscle; for deep inguinal nodes: the femoral vessels Pectineal muscle 38 Medial Loose cellular tissue Posterior Anterior border of the internal iliac lymph nodes and loose cellular tissue 4 Planing CT: Technical Notes * In the treatment planning of radiation therapy, the positioning and immobilization of the patient established when preparing CT simulation are especially important.
The CT scanning technique should be spiral and single-slice, since it affords higher resolution and provides a greater amount of volumetric information for delineation of radiotherapy target volumes compared with sequential acquisition [80, 93, 94]. It is usually performed during free breathing. In the presence of peripheral lung tumors an optimized version of the above-mentioned procedure may be considered, by acquiring three slow CT scans (4 s per scan) obtained during quiet respiration .
The arms usually lie along the body, but patients may also be asked to cross their arms over their chest so as to lower their shoulders and reduce the occurrence of “beam hardening artifacts” on CT images. 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).
A Guide for Delineation of Lymph Nodal Clinical Target Volume in Radiation Therapy by Giampiero Ausili Cefaro, Carlos A. Perez, Domenico Genovesi, Annamaria Vinciguerra