Three dimensional location of internal mammary lymph nodes (IMLN) in patients undergoing radiation therapy: Implications for portal planning
In breast cancer patients (pts.), radiation therapy (RT) techniques must account for individual anatomy to ensure optimal coverage of tumor regions. Knowledge of IMLN localization is often useful when tangential or anterior (AP) portals are used. We have analyzed IMLN localization in 167 pts. who had lymphoscintigraphy (LS) for RT planning. Parallel and slant-hole collimation were used for imaging. Ribs were defined with lead markers, and a chest x-ray was taken to localize marker positions. Rib and interspace (IS) location of each node was recorded. 768 nodes were analyzed for position and RT coverage (Rib 1-IS 5). The X-bar number of nodes was 4/6 pt. with no significant difference in number by age. Cross-over to the opposite IMLN chain occurred in 13.8% of cases (56.5% manubrial, 17.4% midsternal, and 26.1% xiphoid). With nodes in the idealized tangential field (those from IS 2-5, anterior to a 35/sup 0/ plane entering the thorax 3 cm contralateral to midline, at least one node could have been missed in 31 pts. (18.6%), represented by 44 of 768 nodes (5.7%). In conclusion, RT portals based on ''idealized pts.'' can result in both over and undertreated nodes; LS will obviate this and provide data for individualized treatment planning.
- Research Organization:
- Depts. of Radiology, Radiation Therapy and Biostatics, Dana-Farber Cancer Institute, Boston, MA
- OSTI ID:
- 5971620
- Report Number(s):
- CONF-850611-; TRN: 87-039562
- Journal Information:
- J. Nucl. Med.; (United States), Vol. 26:5; Conference: 32. annual meeting of the Society of Nuclear Medicine, Houston, TX, USA, 2 Jun 1985
- Country of Publication:
- United States
- Language:
- English
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Related Subjects
LYMPH NODES
SCINTISCANNING
MAMMARY GLANDS
ANATOMY
NEOPLASMS
RADIOTHERAPY
PLANNING
DIAGNOSTIC TECHNIQUES
RADIOISOTOPE SCANNING
BODY
COUNTING TECHNIQUES
DISEASES
GLANDS
LYMPHATIC SYSTEM
MEDICINE
NUCLEAR MEDICINE
ORGANS
RADIOLOGY
THERAPY
550602* - Medicine- External Radiation in Diagnostics- (1980-)
550604 - Medicine- Unsealed Radionuclides in Therapy- (1980-)
550601 - Medicine- Unsealed Radionuclides in Diagnostics