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EDUCATION EXHIBIT |
1 From the Departments of Radiology (A.S., S.L.L., S.L.A.) and Medicine (P.F.), Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Founders 202, Boston, MA 02114; and the Department of Radiology and Herbert J. Frensley Center for Imaging Research, Baylor College of Medicine, Houston, Tex (L.A.H., K.H.T.). Presented as an education exhibit at the 2002 RSNA scientific assembly. Received March 19, 2003; revision requested April 29; final revision received November 6; accepted November 7. Address correspondence to A.S. (e-mail: asharma2@partners.org).
There are different lymphatic drainage pathways in the thorax that are relevant in the staging of lung cancer, breast cancer, lymphoma, esophageal cancer, and malignant mesothelioma. To properly search for metastatic spread, it is important to carefully evaluate the specific nodal stations that drain the thoracic structures from which a primary tumor originates. Because size criteria have limitations in the prediction of nodal status, pathologic confirmation is essential for accurate staging. Computed tomography (CT) is useful in helping the surgeon or interventional radiologist determine the most appropriate approach for nodal sampling. Fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) has an increasing role in detection of diseased lymph nodes that appear normal at CT alone, particularly when FDG PET images are fused with CT images. However, the role of radiologic imaging extends beyond initial staging and the guidance of interventions to include posttreatment assessment and the detection of recurrent disease. Therefore, at all levels of cancer imaging, it is essential to identify the relevant lymph node regions and their relations to the primary tumor.
© RSNA, 2004
Index Terms: Breast neoplasms, metastases, 00.32 • Esophagus, neoplasms, 71.32 • Lung neoplasms, metastases, 60.32 • Lymphatic system, CT, 99.1291 • Lymphatic system, neoplasms, 99.83 • Lymphoma, staging, 99.834 • Mesothelioma, 66.3254 • Thorax, neoplasms, 99.83
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