CT-based definition of thoracic lymph node stations: an atlas from the University of Michigan.
OBJECTIVE
Accurate delineation of the mediastinal and hilar lymph node regions is essential for a reproducible definition of target volumes used in conformal irradiation of non-small-cell lung cancer. The goal of this work was to generate a consensus to delineate these nodal regions based on definitions from the American Joint Committee on Cancer.


METHODS
A dedicated thoracic radiologist, thoracic surgeon, medical physicist, and three radiation oncologists were gathered to generate a three-dimensional radiologic description for the mediastinal and hilar nodal regions on axial CT scans. This paper proposes an atlas of most of the lymph node stations described by Mountain and Dresler.


RESULTS
The CT boundaries of lymph node stations 1-2, 3, 4, 5, 6, 7, 8, 10-11 were defined on axial CT, along with image illustrations.


CONCLUSIONS
These CT-based illustrative definitions will provide guidelines for clinical practice and studies evaluating incidental radiation in radiotherapy. Studies are ongoing at the University of Michigan to measure quantitatively the incidental nodal radiation received by patients with non-small-cell lung cancer.
Chapet
Olivier
O
Department of Radiation Oncology, University of Michigan, Ann Arbor, MI 48109, USA.
Kong
Feng-Ming
FM
Quint
Leslie E
LE
Chang
Andrew C
AC
Ten Haken
Randall K
RK
Eisbruch
Avraham
A
Hayman
James A
JA
D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008482:Mediastinum; D008488:Medical Illustration; D008824:Michigan; D014057:Tomography, X-Ray Computed; D014495:Universities