FDG / PET-CT based lymph node atlas in breast cancer patients

The aim of this study was to localize loco-regional lymph node metastases (LN) using FDG-PET datasets in 235 patients with 580 lymph nodes. A comprehensive LN atlas was created in this study comprising the largest number of lymph node metastases so far. Our quantitative data illustrate where lymph node metastases occur in different clinical situations and present areas at high risk (i.e "hot spots" of lymph node metastases). The ESTRO CTV and RTOG CTV do not provide coverage of the whole loco-regional lymphatic drainage. Whether target volumes that cover the whole loco-regional lymphatic drainage system are necessary and result in an improved oncological outcome is up to future studies to examine.

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