Document Detail


Pelvic lymph node topography for radiotherapy treatment planning from ferumoxtran-10 contrast-enhanced magnetic resonance imaging.
MedLine Citation:
PMID:  19095369     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To define a population-based pelvic lymph node clinical target volume (CTV) for radiotherapy treatment planning using magnetic resonance (MR) imaging and the ultrasmall superparamagnetic iron oxide lymph node contrast agent ferumoxtran-10. METHODS AND MATERIALS: A total of 55 eligible patients with endometrial, cervical, prostate, or bladder cancer underwent MR imaging sessions before and after contrast administration on 2 consecutive days. Ferumoxtran-10 was administered immediately after the first scan. The three-dimensional spatial distribution of the pelvic lymph nodes was determined in relation to adjacent vessels and other musculoskeletal landmarks, from which guidelines for determining a nodal CTV in individual patients were developed. RESULTS: On average, 30 lymph nodes (range, five to 62 nodes) were identified in each patient. The distribution of nodal distances to the closest artery or vein was observed to vary in different anatomic regions. Symmetrical three-dimensional margins of expansion around the distal para-aortic (12 mm), common iliac (10 mm), external iliac (9 mm), and internal iliac (10 mm) vessels, drawn in continuity with a 12-mm expansion anterior to the sacrum and a 22-mm expansion medial to the pelvic sidewall, were shown to encompass the majority of detectable lymph nodes in most patients. CONCLUSION: Use of MR lymphography with ferumoxtran-10 provides an objective description of lymph node locations for radiotherapy planning. Use of this nodal CTV model in clinical practice could ensure a high probability of encompassing the regions at risk of harboring metastatic disease while minimizing the dose to adjacent normal tissues.
Authors:
Robert Dinniwell; Philip Chan; Gregory Czarnota; Masoom A Haider; Kartik Jhaveri; Michael Jewett; Anthony Fyles; David Jaffray; Michael Milosevic
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-12-25
Journal Detail:
Title:  International journal of radiation oncology, biology, physics     Volume:  74     ISSN:  1879-355X     ISO Abbreviation:  Int. J. Radiat. Oncol. Biol. Phys.     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-06-01     Completed Date:  2009-06-18     Revised Date:  2009-12-02    
Medline Journal Info:
Nlm Unique ID:  7603616     Medline TA:  Int J Radiat Oncol Biol Phys     Country:  United States    
Other Details:
Languages:  eng     Pagination:  844-51     Citation Subset:  IM    
Affiliation:
Radiation Medicine Program, Princess Margaret Hospital/Ontario Cancer Institute, University Health Network, Toronto, Canada.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Aorta, Abdominal / anatomy & histology
Contrast Media / diagnostic use*
Dextrans
Endometrial Neoplasms / pathology,  radiotherapy
Female
Ferrosoferric Oxide
Humans
Iliac Artery / anatomy & histology
Iliac Vein / anatomy & histology
Iron / diagnostic use*
Lymph Nodes / pathology*
Lymphatic Metastasis / pathology*
Magnetic Resonance Imaging / methods*
Male
Medical Illustration
Middle Aged
Oxides / diagnostic use*
Pelvic Neoplasms / pathology*
Pelvis
Prostatic Neoplasms / pathology,  radiotherapy
Urinary Bladder Neoplasms / pathology,  radiotherapy
Uterine Cervical Neoplasms / pathology,  radiotherapy
Chemical
Reg. No./Substance:
0/Contrast Media; 0/Oxides; 0/ferumoxtran-10; 1317-61-9/Ferrosoferric Oxide; 7439-89-6/Iron; 9004-54-0/Dextrans

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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