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- W2039133091 abstract "Purpose/Objective: Adjuvant inguinal lymph node irradiation is often used in patients with penile, vulvar, low vaginal and perianal malignancies. However, the location and depth of the inguinal lymph nodes has not been well defined, and RT volumes are frequently related to bony landmarks or femoral vascular anatomy. We utilized a new superparamagnetic MRI contrast agent Combidex® (ferumoxtran-10, Advanced Magnetics, Inc., Cambridge, MA) that is specific for nodal tissue to define the RT target volume for adjuvant inguinal lymph node irradiation. Materials/Methods: A cohort of 45 patients undergoing radical treatment for pelvic malignancies was enrolled in this prospective study. None had gross inguinal lymph node metastases. A pre-contrast MRI scan was obtained from the mid-abdomen to below the pelvic bone. Combidex (2.6 mg Fe/kg) was infused intravenously over 30 min, and a second MRI scan was performed 24 hours after the infusion. T2W and T2* images 3 mm apart were acquired and imported to a 3D image analysis program (3D-Doctor, Able Software Corp., Lexington, MA) for nodal identification and evaluation. The number and size of the inguinal nodes, depth from the skin surface, and distance from the femoral artery were recorded. Results: The median number of right inguinal nodes was 7 (range 2–11) while on the left it was 6.5 (1–11). Median size was 0.6 (0.2–1.2) cm. The median depth from the skin surface was 2.3 (1–6.3) cm on the right and 2.8 (1.5–7.1) cm on the left. Distance from the right femoral artery was 1.8 (0.7–4.1) cm, and from the left 1.9 (0.7–4.5) cm. Conclusions: MRI images enhanced with Combidex reliably identifies inguinal lymph nodes and provided a reference for adjuvant radiation treatment planning. These nodes may be deeply situated at a distance from the femoral vessels, raising concern about geographic miss with conventional planning, and reinforcing the potential value of high-resolution contrast-enhanced imaging to identify nodal volume in individual patients." @default.
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- W2039133091 date "2005-10-01" @default.
- W2039133091 modified "2023-09-27" @default.
- W2039133091 title "Topographic Analysis of Inguinal Lymph Nodes using Combidex Enhanced Magnetic Resonance Imaging: Defining the Radiation Therapy Volume for Tumors of the Lower Pelvis and Genitalia" @default.
- W2039133091 doi "https://doi.org/10.1016/j.ijrobp.2005.07.922" @default.
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