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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

An axial contrast-enhanced CT demonstrating an enlarged heterogeneous right external iliac lymph node (arrow) in a 64-year-old patient with endometrial cancer.
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Figure 3: An axial contrast-enhanced CT demonstrating an enlarged heterogeneous right external iliac lymph node (arrow) in a 64-year-old patient with endometrial cancer.

Mentions: Heterogeneous appearance. Large metastatic nodes frequently appear heterogeneous on contrast-enhanced CT (Fig. 3) and MRI. A lower density nodal centre on CT can be as a result of necrosis and this is particularly common in primary squamous cell cancers of the head and neck and even normal-sized necrotic nodes should be considered malignant in these patients. On T2-weighted MRI central necrosis demonstrates high signal, and this has a very high positive predicative value in patients with cervical cancer[18]. In patients with rectal cancer, nodal signal heterogeneity is a feature of malignant mesorectal lymph nodes on high-resolution T2-weighted MR imaging[16].


Nodal staging.

Ganeshalingam S, Koh DM - Cancer Imaging (2009)

An axial contrast-enhanced CT demonstrating an enlarged heterogeneous right external iliac lymph node (arrow) in a 64-year-old patient with endometrial cancer.
© Copyright Policy
Related In: Results  -  Collection

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

Figure 3: An axial contrast-enhanced CT demonstrating an enlarged heterogeneous right external iliac lymph node (arrow) in a 64-year-old patient with endometrial cancer.
Mentions: Heterogeneous appearance. Large metastatic nodes frequently appear heterogeneous on contrast-enhanced CT (Fig. 3) and MRI. A lower density nodal centre on CT can be as a result of necrosis and this is particularly common in primary squamous cell cancers of the head and neck and even normal-sized necrotic nodes should be considered malignant in these patients. On T2-weighted MRI central necrosis demonstrates high signal, and this has a very high positive predicative value in patients with cervical cancer[18]. In patients with rectal cancer, nodal signal heterogeneity is a feature of malignant mesorectal lymph nodes on high-resolution T2-weighted MR imaging[16].

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