Comparison of the distribution of lymph node metastases compared to healthy lymph nodes in breast cancer
Abstract Background Current literature lacks a comparison of lymph node metastases and non-pathological lymph nodes distribution in breast cancer patients. The aim of the current retrospective study was to generate a comprehensive atlas of the lymph node system. Methods 143 breast cancer patients un...
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| Format: | Article |
| Language: | English |
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BMC
2022-02-01
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| Series: | Radiation Oncology |
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| Online Access: | https://doi.org/10.1186/s13014-021-01964-6 |
| _version_ | 1818486404541317120 |
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| author | Kai J. Borm Lucia Ernst Julia Voppichler Markus Oechsner Mathias Düsberg Gabriel Buschner Wolfgang Weber Stephanie E. Combs Marciana N. Duma |
| author_facet | Kai J. Borm Lucia Ernst Julia Voppichler Markus Oechsner Mathias Düsberg Gabriel Buschner Wolfgang Weber Stephanie E. Combs Marciana N. Duma |
| author_sort | Kai J. Borm |
| collection | DOAJ |
| description | Abstract Background Current literature lacks a comparison of lymph node metastases and non-pathological lymph nodes distribution in breast cancer patients. The aim of the current retrospective study was to generate a comprehensive atlas of the lymph node system. Methods 143 breast cancer patients underwent F-18-FDG-PET/CT (PET/CT) imaging for staging purposes and were diagnosed with regional lymph node metastases. Based on the PET/CT data set a total of 326 lymph node metastases and 1826 non-pathological lymph nodes were detected and contoured manually in the patient collective. Using rigid and deformable registration algorithms all structures were transferred to a template planning CT of a standard patient. Subsequently, a 3D-atlas of the distribution of lymph node metastases and non-pathological lymph nodes were generated and compared to each other. Results Both, lymph node metastases and non-pathological lymph nodes, accumulated in certain areas (“hot-spots”) within the lymphatic drainage system. However large differences regarding the distribution patterns were detected: lymph node metastases hot spots occurred in close proximity to the subclavian vein in level I-III, whereas the non-pathological lymph nodes accumulated mostly (within a wider range) in level I. In level II and III lymph node metastases exceeded clearly the areas in which non-pathological lymph nodes occurred. Conclusion Lymph node metastases and non-pathological lymph node distribution within the lymph node system differ clearly. Based on our results, an individual adjustment of the CTV in order to include visible lymph nodes in level II and III should be discussed. |
| first_indexed | 2024-12-10T16:22:30Z |
| format | Article |
| id | doaj.art-547ad93cc8fa4c86bd63cd6acbd0da66 |
| institution | Directory Open Access Journal |
| issn | 1748-717X |
| language | English |
| last_indexed | 2024-12-10T16:22:30Z |
| publishDate | 2022-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj.art-547ad93cc8fa4c86bd63cd6acbd0da662022-12-22T01:41:45ZengBMCRadiation Oncology1748-717X2022-02-011711910.1186/s13014-021-01964-6Comparison of the distribution of lymph node metastases compared to healthy lymph nodes in breast cancerKai J. Borm0Lucia Ernst1Julia Voppichler2Markus Oechsner3Mathias Düsberg4Gabriel Buschner5Wolfgang Weber6Stephanie E. Combs7Marciana N. Duma8Department of Radiation Oncology, Medical School, Klinikum rechts der Isar, Technical University MunichDepartment of Radiation Oncology, Medical School, Klinikum rechts der Isar, Technical University MunichDepartment of Radiation Oncology, Medical School, Klinikum rechts der Isar, Technical University MunichDepartment of Radiation Oncology, Medical School, Klinikum rechts der Isar, Technical University MunichDepartment of Radiation Oncology, Medical School, Klinikum rechts der Isar, Technical University MunichDepartment of Nuclear Medicine, Medical School, Klinikum rechts der Isar, Technical University MunichDepartment of Nuclear Medicine, Medical School, Klinikum rechts der Isar, Technical University MunichDepartment of Radiation Oncology, Medical School, Klinikum rechts der Isar, Technical University MunichDepartment of Radiation Oncology, Medical School, Klinikum rechts der Isar, Technical University MunichAbstract Background Current literature lacks a comparison of lymph node metastases and non-pathological lymph nodes distribution in breast cancer patients. The aim of the current retrospective study was to generate a comprehensive atlas of the lymph node system. Methods 143 breast cancer patients underwent F-18-FDG-PET/CT (PET/CT) imaging for staging purposes and were diagnosed with regional lymph node metastases. Based on the PET/CT data set a total of 326 lymph node metastases and 1826 non-pathological lymph nodes were detected and contoured manually in the patient collective. Using rigid and deformable registration algorithms all structures were transferred to a template planning CT of a standard patient. Subsequently, a 3D-atlas of the distribution of lymph node metastases and non-pathological lymph nodes were generated and compared to each other. Results Both, lymph node metastases and non-pathological lymph nodes, accumulated in certain areas (“hot-spots”) within the lymphatic drainage system. However large differences regarding the distribution patterns were detected: lymph node metastases hot spots occurred in close proximity to the subclavian vein in level I-III, whereas the non-pathological lymph nodes accumulated mostly (within a wider range) in level I. In level II and III lymph node metastases exceeded clearly the areas in which non-pathological lymph nodes occurred. Conclusion Lymph node metastases and non-pathological lymph node distribution within the lymph node system differ clearly. Based on our results, an individual adjustment of the CTV in order to include visible lymph nodes in level II and III should be discussed.https://doi.org/10.1186/s13014-021-01964-6Breast cancerLymph node irradiationLymphatic systemLymph node metastasesLymph node mapping |
| spellingShingle | Kai J. Borm Lucia Ernst Julia Voppichler Markus Oechsner Mathias Düsberg Gabriel Buschner Wolfgang Weber Stephanie E. Combs Marciana N. Duma Comparison of the distribution of lymph node metastases compared to healthy lymph nodes in breast cancer Radiation Oncology Breast cancer Lymph node irradiation Lymphatic system Lymph node metastases Lymph node mapping |
| title | Comparison of the distribution of lymph node metastases compared to healthy lymph nodes in breast cancer |
| title_full | Comparison of the distribution of lymph node metastases compared to healthy lymph nodes in breast cancer |
| title_fullStr | Comparison of the distribution of lymph node metastases compared to healthy lymph nodes in breast cancer |
| title_full_unstemmed | Comparison of the distribution of lymph node metastases compared to healthy lymph nodes in breast cancer |
| title_short | Comparison of the distribution of lymph node metastases compared to healthy lymph nodes in breast cancer |
| title_sort | comparison of the distribution of lymph node metastases compared to healthy lymph nodes in breast cancer |
| topic | Breast cancer Lymph node irradiation Lymphatic system Lymph node metastases Lymph node mapping |
| url | https://doi.org/10.1186/s13014-021-01964-6 |
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