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Detailed Structure and Function of Lymph Nodes

Detailed Structure and Function of Lymph Nodes

Lymph nodes are bean-shaped structures that cluster along the lymphatic vessels in the inguinal, axillary, and cervical regions. Each node is divided into compartments by a capsule that extends trabeculae inward.
From a histological perspective, lymph nodes can be split into two main areas: the superficial cortex and the deep medulla. The outer cortex is populated by dendritic cells, macrophages, and B lymphocytes, which are densely packed into follicles. When these B-lymphocytes are presented...

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Related Experiment Video

Updated: Aug 7, 2025

Irradiator Commissioning and Dosimetry for Assessment of LQ α and β Parameters, Radiation Dosing Schema, and in vivo Dose Deposition

Irradiator Commissioning and Dosimetry for Assessment of LQ α and β Parameters, Radiation Dosing Schema, and in vivo Dose Deposition

Published on: March 11, 2021

Internal Guidelines for Reducing Lymph Node Contour Variability in Total Marrow and Lymph Node Irradiation.

Damiano Dei^1,2, Nicola Lambri^1,2, Sara Stefanini^1,2

¹Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy.

|March 11, 2023

Summary

This summary is machine-generated.

New internal contour guidelines significantly reduced lymph node delineation variability in total marrow and lymph node irradiation (TMLI) treatments. This improved consistency ensures safe and effective radiation delivery for TMLI patients.

Keywords:

TMLI clinical target volume conditioning regimen contour definition guidelines interobserver variability leukemia radiotherapy

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Published on: September 8, 2021

Area of Science:

Radiation Oncology
Medical Physics
Radiotherapy Planning

Background:

Total marrow and lymph node irradiation (TMLI) involves complex target volumes including bones, spleen, and lymph nodes.
Accurate delineation of lymph node chains is challenging, impacting treatment consistency.
Inter- and intraobserver variability in lymph node contouring can affect radiation therapy outcomes.

Purpose of the Study:

To evaluate the impact of introducing internal contour guidelines on lymph node delineation variability in TMLI.
To assess the efficacy of new guidelines in reducing inter- and intraobserver variations.
To determine the dosimetric implications of improved contouring consistency.

Main Methods:

Ten TMLI patients were randomly selected for guideline evaluation.
Lymph node clinical target volumes (CTV_LN) were recontoured using new guidelines (CTV_LN_GL_RO1) and compared to historical guidelines (CTV_LN_Old).
Topological (Dice Similarity Coefficient - DSC) and dosimetric (V95) metrics were calculated to assess contour agreement.

Main Results:

Mean DSC improved significantly from 0.82 (historical) to 0.97 (guidelines) for interobserver variability.
Intraobserver variability showed high agreement with mean DSC of 0.98 with guidelines.
Mean CTV_LN-V95 dose differences were minimal (0.03-0.1%) with the new guidelines, indicating excellent target coverage.

Conclusions:

The new internal contour guidelines effectively reduced lymph node delineation variability in TMLI.
High agreement in target coverage (V95) suggests historical margins were safe.
The findings support the adoption of these guidelines to enhance TMLI treatment precision and consistency.