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Nodal staging.

Ganeshalingam S, Koh DM - Cancer Imaging (2009)

Bottom Line: Lymph node metastases are a poor prognostic indicator in many tumours and therefore accurate identification during staging is important prior to commencing treatment.The presence of lymph node metastases can significantly alter patient management and therefore accurate diagnosis of the presence and extent of nodal disease can help optimise patient management.The clinical role of positron emission tomography-CT imaging for nodal staging is discussed and emerging imaging techniques that may further improve nodal staging accuracy are surveyed.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Radiology, Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT, UK. skandadasganesh@yahoo.co.uk

ABSTRACT
Lymph node metastases are a poor prognostic indicator in many tumours and therefore accurate identification during staging is important prior to commencing treatment. The presence of lymph node metastases can significantly alter patient management and therefore accurate diagnosis of the presence and extent of nodal disease can help optimise patient management. In this review, the radiologic features that aid in the differentiation of malignant and benign lymph nodes are discussed. The keys to successful interpretation on cross-sectional computed tomography (CT) and magnetic resonance imaging of nodal metastases are highlighted. The clinical role of positron emission tomography-CT imaging for nodal staging is discussed and emerging imaging techniques that may further improve nodal staging accuracy are surveyed.

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Related in: MedlinePlus

(A) An ultrasound demonstrating a normal lymph node in a 24-year-old man. (B) An ultrasound demonstrating fine-needle aspiration of an irregular right supraclavicular lymph node in a 46-year-old woman with breast cancer.
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Figure 1: (A) An ultrasound demonstrating a normal lymph node in a 24-year-old man. (B) An ultrasound demonstrating fine-needle aspiration of an irregular right supraclavicular lymph node in a 46-year-old woman with breast cancer.

Mentions: Superficial lymph nodes, particularly in the head and neck, axilla and inguinal regions are amenable to ultrasound (US) evaluation. A normal lymph node is ovoid in shape, hypoechoic to the adjacent muscle and frequently contains an echogenic fatty hilum (Fig. 1a). The hilum is a linear, echogenic, non-shadowing structure that contains the nodal vessels and it appears continuous with the fat around the node. The key advantage of US is the ability to perform an image-guided cytologic sample (Fig. 1b). The drawbacks of ultrasound include significant intra- and inter-operator variability and it is unreliable for the evaluation of deep metastatic lymph nodes. Deep seated lymph nodes in the body are also difficult to visualise.Figure 1


Nodal staging.

Ganeshalingam S, Koh DM - Cancer Imaging (2009)

(A) An ultrasound demonstrating a normal lymph node in a 24-year-old man. (B) An ultrasound demonstrating fine-needle aspiration of an irregular right supraclavicular lymph node in a 46-year-old woman with breast cancer.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2821588&req=5

Figure 1: (A) An ultrasound demonstrating a normal lymph node in a 24-year-old man. (B) An ultrasound demonstrating fine-needle aspiration of an irregular right supraclavicular lymph node in a 46-year-old woman with breast cancer.
Mentions: Superficial lymph nodes, particularly in the head and neck, axilla and inguinal regions are amenable to ultrasound (US) evaluation. A normal lymph node is ovoid in shape, hypoechoic to the adjacent muscle and frequently contains an echogenic fatty hilum (Fig. 1a). The hilum is a linear, echogenic, non-shadowing structure that contains the nodal vessels and it appears continuous with the fat around the node. The key advantage of US is the ability to perform an image-guided cytologic sample (Fig. 1b). The drawbacks of ultrasound include significant intra- and inter-operator variability and it is unreliable for the evaluation of deep metastatic lymph nodes. Deep seated lymph nodes in the body are also difficult to visualise.Figure 1

Bottom Line: Lymph node metastases are a poor prognostic indicator in many tumours and therefore accurate identification during staging is important prior to commencing treatment.The presence of lymph node metastases can significantly alter patient management and therefore accurate diagnosis of the presence and extent of nodal disease can help optimise patient management.The clinical role of positron emission tomography-CT imaging for nodal staging is discussed and emerging imaging techniques that may further improve nodal staging accuracy are surveyed.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Radiology, Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT, UK. skandadasganesh@yahoo.co.uk

ABSTRACT
Lymph node metastases are a poor prognostic indicator in many tumours and therefore accurate identification during staging is important prior to commencing treatment. The presence of lymph node metastases can significantly alter patient management and therefore accurate diagnosis of the presence and extent of nodal disease can help optimise patient management. In this review, the radiologic features that aid in the differentiation of malignant and benign lymph nodes are discussed. The keys to successful interpretation on cross-sectional computed tomography (CT) and magnetic resonance imaging of nodal metastases are highlighted. The clinical role of positron emission tomography-CT imaging for nodal staging is discussed and emerging imaging techniques that may further improve nodal staging accuracy are surveyed.

Show MeSH
Related in: MedlinePlus