A population-based atlas and clinical target volume for the head-and-neck lymph nodes.

摘要: Abstract Purpose To develop a population-based three-dimensional lymph node target volume of the head and neck. Methods materials The T2 weighted axial magnetic resonance imaging (MRI) images 35 patients with known neck cancer were reviewed. An experienced radiologist marked each (LN) electronically. distributed to one 12 levels level representing distinct portion based on external contours presence anatomic structures. LNs five different symbols distinguish superior/inferior extent LN within level. With categorization image into neck, registration was limited two dimensions. Nonlinear transformation accounted for inter-patient differences although no local warping used. co-registration used recognizable landmarks (vertebral body, mandible, maxilla, clivus as well sternocleidomastoid muscle, skin contour, spinal cord) match patient anatomy. Results In total, 503 co-registered baseline images. majority co-registrations good quality; 361, 122, 20 scored global, limited, poor respectively. One thousand fifty seven marked, 122 submandibular submental LN. Among A, B, C, D, E, F, G, H, 22, 44, 206, 199, 196, 175, 63, Noteworthy variation observed among nodal groups that are summarized in representative Conclusions Image series generates valuable map can be guide delineation elective volume. Significant location seen all groups. medial border internal jugular vein an important landmark structure delineating clinical and, reason, intravenous contrast is recommended improve visualization. appear space anterior lateral gland found mostly along inferior edge mandible. retropharyngeal does vary but their not any other structure. provides another collaborating piece evidence defining