title: CT localization of axillary lymph nodes in relation to the humeral head: significance of arm position for radiation therapy planning.
abstract: Irradiation of the axillary nodes is often indicated in the clinical radiotherapy of patients with lymphoma and breast cancer. The relative location of the axillary nodes and the humeral head has historically been estimated based on lymphangiographic data. Since CT offers more precise definition, the axillary nodal region in relation to the humeral head was systematically studied in 61 patients undergoing CT simulation for breast conservation therapy. Differences in arm position (degree of abduction) significantly affected the location of the axillary nodal region in relation to the humeral head. With the arm abducted beyond 55 degrees, humeral head blocking would result in blocking of some of the axillary nodes.
authors.affiliation: Department of Radiation Oncology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO 63110, USA. mansur@radonc.wustl.edu
authors.forename: David B
authors.initials: DB
authors.lastname: Mansur
authors.forename: Feng-Ming
authors.initials: FM
authors.lastname: Kong
authors.forename: Issam
authors.initials: I
authors.lastname: El Naqa
authors.forename: Marie E
authors.initials: ME
authors.lastname: Taylor
authors.forename: Imran
authors.initials: I
authors.lastname: Zoberi
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Bradley
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Perez
authors.forename: Eric E
authors.initials: EE
authors.lastname: Klein
mesh_terms: D001365:Axilla / Q000000981:diagnostic imaging* / Q000528:radiation effects; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D006811:Humerus / Q000000981:diagnostic imaging; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology; D015182:Lymphatic Irradiation / Q000379:methods*; D008207:Lymphatic Metastasis; D009361:Neoplasm Invasiveness / Q000473:pathology; D011187:Posture; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods