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744 Terms and definitions to describe sonographic features of lymph nodes: consensus opinion from the vulvar international tumor analysis (VITA) group
  1. D Fischerova1,
  2. G Garganese2,3,
  3. H Reina4,
  4. SM Fragomeni5,
  5. D Cibula1,
  6. O Nanka6,
  7. T Rettenbacher7,
  8. AC Testa3,5,
  9. E Epstein8,9,
  10. I Guiggi10,
  11. F Frühauf1,
  12. G Manegold4,
  13. G Scambia3,5 and
  14. L Valentin11,12
  1. 1First Faculty of Medicine, Charles University and General University Hospital in Prague, Department of Obstetrics and Gynecology, Praha 2, Czech Republic
  2. 2Mater Olbia Hospital, Gynecology and Breast Care Center, Olbia, Italy
  3. 3Università Cattolica del Sacro Cuore, Dipartimento Scienze della Vita e Sanità Pubblica, Rome, Italy
  4. 4Women’s Hospital, University Hospital of Basel, Department of Gynecological Ultrasound and Prenatal Diagnostics, Basel, Switzerland
  5. 5Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
  6. 6Institute of Anatomy, First Faculty of Medicine, Charles University, Prague, Czech Republic
  7. 7Universitäts Klinik für Radiologie II, Department Radiologie , Innsbruck, Austria
  8. 8Karolinska Institute, Sodersjukhuset, Department of Clinical Science and Education, Stockholm, Sweden
  9. 9Sodersjukhuset, Department of Obstetrics and Gynecology, Stockholm, Sweden
  10. 10North West Tuscany Hospital, Department of Obstetrics and Gynecology, Livorno, Italy
  11. 11Skåne University Hospital, Department of Obstetrics and Gynecology, Malmö, Sweden
  12. 12Lund University, Department of Clinical Sciences Malmö, Lund, Sweden


Introduction/Background*There is, as yet, no international consensus on ultrasound assessment of lymph nodes in any disease or medical condition. The lack of standardized ultrasound nomenclature to describe lymph nodes makes it difficult to compare results from different ultrasound studies and to find reliable ultrasound features for distinguishing non-infiltrated lymph nodes from those infiltrated by cancer or lymphoma.

Methodology The Vulvar International Tumor Analysis (VITA) collaborative group was established involving gynecologists, gynecologic oncologists and radiologists with expertise in gynecologic cancer, particularly in the ultrasound staging and treatment of vulvar cancer. The steering committee for the study held special meeting to discuss the problems of standardization and to formulate terms and procedures to derive morphologic end-points by B-mode imaging and end-point of vascularity and blood flow by color Doppler imaging. The recommendations of the steering committee were distributed to each participating center and subsequently refined. The following consensus is going to be tested in international multicentric interobserver and diagnostic accuracy studies.

Result(s)*We present a consensus of international multidisciplinary VITA group on terms, definitions and measurements which may be used to describe inguinal lymph nodes on grayscale and color/power Doppler ultrasound. The proposed nomenclature is not limited to inguinal lymph nodes as part of vulvar cancer staging; it can be used for the assessment of peripheral lymph nodes in general, as well as non-peripheral (i.e. parietal or visceral) lymph nodes.

Conclusion*VITA terms and definitions were developed as a basis for international standardization of lymph node assessment by ultrasound and lay the foundations for prospective studies aiming to identify ultrasound features typical of metastases and other pathology in lymph nodes.

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