Distribution of Prostate Sentinel Nodes: A SPECT-Derived Anatomic Atlas

Ganswindt, Ute; Schilling, David; Müller, Arndt-Christian; Bares, Roland; Bartenstein, Peter; Belka, Claus

doi:10.1016/j.ijrobp.2010.01.012

Cited by 78 publications

(44 citation statements)

References 44 publications

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“…Our rates of SLN involvement are somewhat different in comparison to prior studies 8, 15, 19. Ganswindt and coworkers found common iliac and para-aortic SLNs in about 48% and 23% to 25% of patients, respectively 19 .…”

Section: Discussioncontrasting

confidence: 87%

Sentinel lymph node imaging guided IMRT for prostate cancer: Individualized pelvic radiation therapy versus RTOG guidelines

Chen

Johnson

Seo

et al. 2016

Advances in Radiation Oncology

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Purpose/ObjectivesCurrent Radiation Therapy Oncology Group (RTOG) guidelines for pelvic radiation therapy are based on general anatomic boundaries. Sentinel lymph node (SLN) imaging can identify potential sites of lymph node involvement. We sought to determine how tailored radiation therapy fields for prostate cancer would compare to standard RTOG-based fields. Such individualized radiation therapy could prioritize the most important areas to irradiate while potentially avoiding coverage in areas where critical structures would be overdosed. Individualized radiation therapy could therefore increase the therapeutic index of pelvic radiation therapy.Methods and materialsTen intermediate or high-risk prostate cancer patients received androgen deprivation therapy with definitive radiation therapy, including an SLN imaging–tailored elective nodal volume (ENV). For dosimetric analyses, the ENV was recontoured using RTOG guidelines (RTOG_ENV) and on SLNs alone (SLN_ENV). Separate intensity modulated radiation therapy (IMRT) plans were optimized using RTOG_ENV and SLN_ENV for each patient. Dosimetric comparisons for these IMRT plans were performed for each patient. Dose differences to targets and critical structures among the different IMRT plans were calculated. Distributions of dose parameters were analyzed using non-parametric methods.ResultsSixty percent of patients had SLNs outside of the RTOG_ENV. The larger volume IMRT plans covering SLN imaging–tailored elective nodal volume exhibited no significant dose differences versus plans covering RTOG_ENV. IMRT plans covering only the SLNs had significantly lower doses to bowel and femoral heads.ConclusionsSLN-guided pelvic radiation therapy can be used to either treat the most critical nodes only or as an addition to RTOG guided pelvic radiation therapy to ensure that the most important nodes are included.

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Section: Discussioncontrasting

confidence: 87%

Sentinel lymph node imaging guided IMRT for prostate cancer: Individualized pelvic radiation therapy versus RTOG guidelines

Chen

Johnson

Seo

et al. 2016

Advances in Radiation Oncology

View full text Add to dashboard Cite

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“…Ganswindt et al reported the distribution of sentinel nodes as detected by single photon emission computed tomography (SPECT) imaging (44). Radioguided surgery helps identify the relevant lymph nodes to be dissected even in regions outside the field of ELD.…”

Section: The Role Of Imaging In Assessing Nodal Status For Prostate Cmentioning

confidence: 99%

“…3) (83). Based on recent studies using sentinel node imaging and the apparent altered pattern of draining flowing treatment in patients with recurrent disease, in selected high-risk patients it is probably prudent to include common iliac and para-aortic nodes as well (44,45,84). The clear advantages that IMRT have over 3DCRT and the associated ability to meet rather strict dose constraints, favors IMRT over WPRT (80)(81)(82).…”

Section: How and What Should We Treat And What About Morbidity?mentioning

confidence: 99%

Pelvic Nodal Radiotherapy in Patients With Unfavorable Intermediate and High-Risk Prostate Cancer: Evidence, Rationale, and Future Directions

Morikawa

Roach

2011

International Journal of Radiation Oncology*Biology*Physics

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“…Insbesondere bei der Festlegung der Lymphabflussbereiche wurde bislang nur auf empirisch definierte anatomische Informationen zurückgegriffen -eine Anpassung an die individuellen Gegebenheiten wurde nur hinsichtlich der Anatomie vorgenommen. Unter Verwendung von Sentineltechniken konnte beim Prostatakarzinom gezeigt werden, dass der individuelle physiologische Lymphabfluss z. T. erheblich von den rein anatomischen Ansätzen abweicht [10]. Neue lymphknotenspezifische MR-Kontrastmittel gestatten eine Detektion makroskopisch befallener Lymphknoten, die noch nicht vergrö-ßert sind [11,12].…”

Section: Bildführung Zur Definition Des "Clinical Target Volume"unclassified

Bildgeführte Strahlentherapie

et al. 2012

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Radiotherapy technology has improved rapidly over the past two decades. New imaging modalities, such as positron emission (computed) tomography (PET, PET-CT) and high-resolution morphological and functional magnetic resonance imaging (MRI) have been introduced into the treatment planning process. Image-guided radiation therapy (IGRT) with 3D soft tissue depiction directly imaging target and normal structures, is currently replacing patient positioning based on patient surface markers, frame-based intracranial and extracranial stereotactic treatment and partially also 2D field verification methods. On-line 3D soft tissue-based position correction unlocked the full potential of new delivery techniques, such as intensity-modulated radiotherapy, by safely delivering highly conformal dose distributions that facilitate dose escalation and hypofractionation. These strategies have already resulted in better clinical outcomes, e.g. in prostate and lung cancer and are expected to further improve radiotherapy results.

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Distribution of Prostate Sentinel Nodes: A SPECT-Derived Anatomic Atlas

Cited by 78 publications

References 44 publications

Sentinel lymph node imaging guided IMRT for prostate cancer: Individualized pelvic radiation therapy versus RTOG guidelines

Sentinel lymph node imaging guided IMRT for prostate cancer: Individualized pelvic radiation therapy versus RTOG guidelines

Pelvic Nodal Radiotherapy in Patients With Unfavorable Intermediate and High-Risk Prostate Cancer: Evidence, Rationale, and Future Directions

Bildgeführte Strahlentherapie

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