Brachial plexus contouring with CT and MR imaging in radiation therapy planning for head and neck cancer

Radiographics : a Review Publication of the Radiological Society of North America, Inc
Minh Tam TruongOsamu Sakai

Abstract

With the increasing use of intensity-modulated radiation therapy (IMRT) for the treatment of head and neck cancer, radiation oncologists are expected to have an in-depth knowledge of the computed tomographic (CT) and magnetic resonance (MR) imaging anatomy of this region to be able to accurately characterize tumor extent and define organs at risk for potential radiation injury. The brachial plexus is a complex anatomic structure in the head and neck adjacent to diseased nodes and elective nodal volumes (ie, nodal areas that are prophylactically treated because they are at high risk for micrometastatic disease) and should, therefore, be carefully identified and contoured at CT prior to IMRT planning. A number of multi-institutional protocols mandate contouring the brachial plexus as an "avoidance structure" (ie, a structure or volume that is at risk for complications of radiation therapy) in the planning of head and neck radiation therapy, and, although little information exists on the best method of doing so consistently, contouring may be facilitated with fusion CT-MR imaging software. With three-dimensional conformal radiation therapy, the brachial plexus is not routinely contoured; therefore, its dose limits are not evaluate...Continue Reading

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Citations

Jul 27, 2011·Nature Reviews. Clinical Oncology·XiaoShen WangAvraham Eisbruch
Feb 1, 2014·Medical Dosimetry : Official Journal of the American Association of Medical Dosimetrists·Paul B RomesserMinh Tam Truong
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Jun 8, 2019·Journal of Medical Imaging and Radiation Oncology·Wenhao ChenChanglin Zou

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