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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 coronal STIR image demonstrating a high signal intensity node(arrow) at right level II region in a 67-year-male patient with squamous cell cancer of the oropharynx.
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Figure 2: A coronal STIR image demonstrating a high signal intensity node(arrow) at right level II region in a 67-year-male patient with squamous cell cancer of the oropharynx.

Mentions: On CT imaging, normal lymph nodes are well demonstrated on CT. They are ovoid in shape and are of soft tissue density. MR imaging must cover the entire pathway of locoregional spread of the tumour being evaluated and the sequences used depend on the anatomic region assessed. Lymph nodes are best demonstrated on T1-weighted images and normal lymph nodes are typically isointense to muscle on T1-weighted imaging, isointense or mildly hyperintense on T2-weighted imaging. Short tau inversion time (STIR) sequences are useful as malignant nodes can be of high signal intensity (Fig. 2). However, this is not specific for malignancy and therefore cannot always be used to differentiate benign from malignant lymph nodes. Furthermore, the signal change of the lymph node during therapy may be helpful for estimating therapy response.


Nodal staging.

Ganeshalingam S, Koh DM - Cancer Imaging (2009)

A coronal STIR image demonstrating a high signal intensity node(arrow) at right level II region in a 67-year-male patient with squamous cell cancer of the oropharynx.
© Copyright Policy
Related In: Results  -  Collection

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

Figure 2: A coronal STIR image demonstrating a high signal intensity node(arrow) at right level II region in a 67-year-male patient with squamous cell cancer of the oropharynx.
Mentions: On CT imaging, normal lymph nodes are well demonstrated on CT. They are ovoid in shape and are of soft tissue density. MR imaging must cover the entire pathway of locoregional spread of the tumour being evaluated and the sequences used depend on the anatomic region assessed. Lymph nodes are best demonstrated on T1-weighted images and normal lymph nodes are typically isointense to muscle on T1-weighted imaging, isointense or mildly hyperintense on T2-weighted imaging. Short tau inversion time (STIR) sequences are useful as malignant nodes can be of high signal intensity (Fig. 2). However, this is not specific for malignancy and therefore cannot always be used to differentiate benign from malignant lymph nodes. Furthermore, the signal change of the lymph node during therapy may be helpful for estimating therapy response.

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