49-year-old female patient with nasopharyngeal carcinoma (NPC) (IMAGE)
Caption
(A) Axial T2-weighted image from MRI examination performed before treatment. Largest RLN is on right side (red line) and has MAD measuring 5 mm. Patient was treated by IMRT. (B) Axial T2-weighted image obtained 3-4 months after completion of IMRT shows decrease in size of right RLN (red line), now with MAD measuring 4 mm. Patient would be considered to have RLN involvement at baseline based on ≥5-mm threshold commonly used in practice, but not by ≥6-mm threshold supported by current study. Patient would not be considered to have RLN involvement using either threshold on examination after IMRT. No disease progression, locoregional recurrence, distant metastasis, or death occurred during follow-up period of 60.7 months. NPC = nasopharyngeal carcinoma; RLN = retropharyngeal lymph node; MAD = minimal axial diameter; IMRT = intensity-modulated radiotherapy.
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