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. 2017 Jan;58(1):86-105.
doi: 10.1093/jrr/rrw076. Epub 2016 Sep 8.

The Japan Lung Cancer Society-Japanese Society for Radiation Oncology consensus-based computed tomographic atlas for defining regional lymph node stations in radiotherapy for lung cancer

Tomoko Itazawa  1   2 , Yukihisa Tamaki  3   4 , Takafumi Komiyama  3   5 , Yasumasa Nishimura  3   6 , Yuko Nakayama  3   7 , Hiroyuki Ito  2   8 , Yasuhisa Ohde  2   9 , Masahiko Kusumoto  2   10 , Shuji Sakai  2   11 , Kenji Suzuki  2   12 , Hirokazu Watanabe  2   13 , Hisao Asamura  2   14
Affiliations

The Japan Lung Cancer Society-Japanese Society for Radiation Oncology consensus-based computed tomographic atlas for defining regional lymph node stations in radiotherapy for lung cancer

Tomoko Itazawa et al. J Radiat Res. 2017 Jan.

Abstract

The purpose of this study was to develop a consensus-based computed tomographic (CT) atlas that defines lymph node stations in radiotherapy for lung cancer based on the lymph node map of the International Association for the Study of Lung Cancer (IASLC). A project group in the Japanese Radiation Oncology Study Group (JROSG) initially prepared a draft of the atlas in which lymph node Stations 1-11 were illustrated on axial CT images. Subsequently, a joint committee of the Japan Lung Cancer Society (JLCS) and the Japanese Society for Radiation Oncology (JASTRO) was formulated to revise this draft. The committee consisted of four radiation oncologists, four thoracic surgeons and three thoracic radiologists. The draft prepared by the JROSG project group was intensively reviewed and discussed at four meetings of the committee over several months. Finally, we proposed definitions for the regional lymph node stations and the consensus-based CT atlas. This atlas was approved by the Board of Directors of JLCS and JASTRO. This resulted in the first official CT atlas for defining regional lymph node stations in radiotherapy for lung cancer authorized by the JLCS and JASTRO. In conclusion, the JLCS-JASTRO consensus-based CT atlas, which conforms to the IASLC lymph node map, was established.

Keywords: CT atlas; lung cancer; lymph nodes; radiotherapy.

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Figures

Fig. 1.
Fig. 1.
Coronal view including the carina.
Fig. 2.
Fig. 2.
Supraclavicular-level cross-section.
Fig. 3.
Fig. 3.
Upper mediastinal cross-section. Line A (light blue dotted line): an imaginary line that smoothly connects the anterior aspects of four vessels (the right brachiocephalic vein, the brachiocephalic artery, the left common carotid artery and the left subclavian artery).
Fig. 4.
Fig. 4.
Aortic arch-level cross-section.
Fig. 5.
Fig. 5.
Azygos arch-level cross-section. Line B (dark blue dotted line): an imaginary line that connects the ascending and descending aorta at the shortest distance. Line C (red dotted line): an imaginary line that is tangential to the posterior aspect of the ascending aorta and is at a right angle to Line B.
Fig. 6.
Fig. 6.
Carina-level cross-section. Line C' (red dotted line): an imaginary line in which Line C is moved parallel to the anterior border of the left main pulmonary artery.
Fig. 7.
Fig. 7.
Sagittal view including the right main bronchus.
Fig. 8.
Fig. 8.
Sagittal view including the left main bronchus.
Fig. 9.
Fig. 9.
Inferior border-level of carina cross-section.
Fig. 10.
Fig. 10.
Subcarinal-level cross-section.
Fig. 11.
Fig. 11.
Left superior lobar bronchial bifurcation-level cross-section.
Fig. 12.
Fig. 12.
Truncus intermedius-level cross-section.
Fig. 13.
Fig. 13.
Atlas of the regional lymph node stations in radiotherapy for lung cancer (serial axial images).
Fig. 13.
Fig. 13.
Atlas of the regional lymph node stations in radiotherapy for lung cancer (serial axial images).
Fig. 13.
Fig. 13.
Atlas of the regional lymph node stations in radiotherapy for lung cancer (serial axial images).
Fig. 13.
Fig. 13.
Atlas of the regional lymph node stations in radiotherapy for lung cancer (serial axial images).
Fig. 13.
Fig. 13.
Atlas of the regional lymph node stations in radiotherapy for lung cancer (serial axial images).
Fig. 13.
Fig. 13.
Atlas of the regional lymph node stations in radiotherapy for lung cancer (serial axial images).
Fig. 13.
Fig. 13.
Atlas of the regional lymph node stations in radiotherapy for lung cancer (serial axial images).
Fig. 13.
Fig. 13.
Atlas of the regional lymph node stations in radiotherapy for lung cancer (serial axial images).
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