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The conundrum of Hodgkin lymphoma nodes: to be or not to be included in the involved node radiation fields. The EORTC-GELA lymphoma group guidelines
- Source :
- Radiotherapy and Oncology, 88, 202-10, Radiotherapy and Oncology, 88, 2, pp. 202-10
- Publication Year :
- 2008
-
Abstract
- Item does not contain fulltext PURPOSE: To develop easily applicable guidelines for the determination of initially involved lymph nodes to be included in the radiation fields. PATIENTS AND METHODS: Patients with supra-diaphragmatic Hodgkin lymphoma. All the imaging procedures were carried out with patients in the treatment position. The prechemotherapy PET/CT was coregistered with the postchemotherapy CT simulation for planning purposes. Initially involved lymph nodes were determined on fused prechemotherapy CT and FDG-PET imaging data. The initial assessment was verified with the postchemotherapy CT scan. RESULTS: The classic guidelines for determining the involvement of lymph nodes were not easily applicable and did not seem to reflect the exact extent of Hodgkin lymphoma. Three simple steps were used to pinpoint involved lymph nodes. First, FDG-PET scans were meticulously analysed to detect lymph nodes that were overlooked on CT imaging. Second, any morphological and/or functional asymmetry was sought on CT and FDG-PET scans. Third, a decrease in size or the disappearance of initially visible lymph nodes on the prechemotherapy CT scan as compared to the postchemotherapy CT scan was considered as surrogate proof of initial involvement. CONCLUSIONS: All the radiological procedures should be performed on patients in the treatment position for proper coregistration. It is highly advisable that all CT and/or CT/PET scans be performed with IV contrast. Using the above-mentioned three simple guidelines, initially involved lymph nodes can be detected with very satisfactory accuracy. It is also emphasized that the classic guidelines (2, 3, 4) can always be used when deemed necessary.
- Subjects :
- medicine.medical_specialty
medicine.medical_treatment
Contrast Media
Fluorodeoxyglucose F18
Interventional oncology [UMCN 1.5]
Node (computer science)
medicine
Humans
Radiology, Nuclear Medicine and imaging
Survival analysis
Lymphatic Irradiation
medicine.diagnostic_test
business.industry
Hematology
medicine.disease
Hodgkin Disease
Survival Analysis
Lymphoma
Radiation therapy
Treatment Outcome
Oncology
Positron emission tomography
Lymphatic Metastasis
Radiological weapon
Practice Guidelines as Topic
Lymph
Tomography
Radiology
Radiopharmaceuticals
Tomography, X-Ray Computed
business
Nuclear medicine
Tomography, Emission-Computed
Subjects
Details
- ISSN :
- 01678140
- Database :
- OpenAIRE
- Journal :
- Radiotherapy and Oncology, 88, 202-10, Radiotherapy and Oncology, 88, 2, pp. 202-10
- Accession number :
- edsair.doi.dedup.....e24dcf2f2ebf5363cb65f8b34fbc857a