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GTV for nodal RT boost
Imaging:
indirect proof (morphological & functional characteristics)
Consider nodal involvement if
1. Nodes are PET positive
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Also PET negative nodes can contain metastases!
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Small ones if cell load low
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Big ones if large necrotic center
2. Nodes > 10 mm short axis diameter on CT or MRI
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Can be reactive!
3. Nodes between 5 and 10 mm on MRI if
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PET positive
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Irregular shape
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Lost nodal architecture
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Inhomogeneous appearance (“necrotic center”)
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Irregular border