open access

Vol 23, No 6 (2018)
Special Issue Papers
Published online: 2018-11-01
Submitted: 2017-09-25
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Lymph flow guided irradiation of regional lymph nodes in patients with cervical cancer: Preliminary analysis of scintigraphic data

Sergey Nikolaevich Novikov, Pavel Ivanovich Krzhivitskii, Sergey Vasilevich Kanaev, Igor Viktorovitch Berlev, Margarita Viktorovna Kargopolova, Zaur Ibragimov, Mikhail Bisyarin, Valentina Vladimirovna Saveleva
DOI: 10.1016/j.rpor.2018.05.008
·
Rep Pract Oncol Radiother 2018;23(6):503-509.

open access

Vol 23, No 6 (2018)
Special Issue Papers
Published online: 2018-11-01
Submitted: 2017-09-25

Abstract

Purpose

To evaluate patterns of lymph flow from primary lesions in patients with cervical cancer and to determine how useful for radiotherapy planning this information can be.

Materials and methods

SPECT–CT visualization of sentinel (SLN) lymph nodes (LNs) was performed in 36 primary patients with IB-IIB cervical cancer. The acquisition started 120–240min after 4 peritumoral injections of 99mTc-radiocolloids (150–300MBq in 0.4–1ml). We determined localization of LN with uptake of radiocolloids, type of lymph flow (mono-, bi-lateral) and lymph flow patterns (supraureteral paracervical, infraureteral paracervical and directly to para-aortic LNs).

Results

SLNs were visualized in 31 of 36 women. Bilateral lymph-flow was detected in 22 (71%), monolateral – in the other 9 (29%) cases. The distribution of SLNs was as follows: external iliac – 64.5%, internal iliac – 54.8%, obturator – 32.2%, common iliac – 35.5% and pre-sacral 3.2%. Para-aortic LNs were visualized in 5 (16.1%) patients. The supraureteral paracervical pattern of lymph flow was identified in 22, infraureteral paracervical – in 4 and their combination – in the other 5 women.

Conclusion

Visualization of an individual pattern of lymph flow from primary cervical cancer can be considered as a promising tool for optimization of the volume of irradiated regional LNs.

Abstract

Purpose

To evaluate patterns of lymph flow from primary lesions in patients with cervical cancer and to determine how useful for radiotherapy planning this information can be.

Materials and methods

SPECT–CT visualization of sentinel (SLN) lymph nodes (LNs) was performed in 36 primary patients with IB-IIB cervical cancer. The acquisition started 120–240min after 4 peritumoral injections of 99mTc-radiocolloids (150–300MBq in 0.4–1ml). We determined localization of LN with uptake of radiocolloids, type of lymph flow (mono-, bi-lateral) and lymph flow patterns (supraureteral paracervical, infraureteral paracervical and directly to para-aortic LNs).

Results

SLNs were visualized in 31 of 36 women. Bilateral lymph-flow was detected in 22 (71%), monolateral – in the other 9 (29%) cases. The distribution of SLNs was as follows: external iliac – 64.5%, internal iliac – 54.8%, obturator – 32.2%, common iliac – 35.5% and pre-sacral 3.2%. Para-aortic LNs were visualized in 5 (16.1%) patients. The supraureteral paracervical pattern of lymph flow was identified in 22, infraureteral paracervical – in 4 and their combination – in the other 5 women.

Conclusion

Visualization of an individual pattern of lymph flow from primary cervical cancer can be considered as a promising tool for optimization of the volume of irradiated regional LNs.

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Keywords

Sentinel lymph nodes; Cervical cancer; Radiotherapy; Lymph flow; SPECT–CT

About this article
Title

Lymph flow guided irradiation of regional lymph nodes in patients with cervical cancer: Preliminary analysis of scintigraphic data

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 23, No 6 (2018)

Pages

503-509

Published online

2018-11-01

DOI

10.1016/j.rpor.2018.05.008

Bibliographic record

Rep Pract Oncol Radiother 2018;23(6):503-509.

Keywords

Sentinel lymph nodes
Cervical cancer
Radiotherapy
Lymph flow
SPECT–CT

Authors

Sergey Nikolaevich Novikov
Pavel Ivanovich Krzhivitskii
Sergey Vasilevich Kanaev
Igor Viktorovitch Berlev
Margarita Viktorovna Kargopolova
Zaur Ibragimov
Mikhail Bisyarin
Valentina Vladimirovna Saveleva

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