Functional Imaging in Clinical Use for the Assessment of Lymph Nodes in Oncological Patients

Abstract

The application of functional imaging techniques in the evaluation of lymph nodes has supposed a qualitative improvement in their detection and characterization. Compared with classical morphological criteria, functional imaging techniques have demonstrated higher accuracy for outcome prediction in oncological malignancies and in treatment monitorization. PET-CT and DWI are the most extended functional techniques used in clinical practice for lymph nodes characterization, evaluating functional characteristics such as metabolism and cellularity. There are other functional techniques to assess angiogenesis of lymph nodes, like DCE-CT and DCE-MRI. Direct and indirect lymphography and the use of specific lymphotropic contrast agents allow the evaluation of lymph paths and also the study of the internal structure of lymph nodes. Ultrasound functional techniques such as elastography and contrast-enhanced ultrasonography may be used as useful complementary tools in superficial lymph node characterization. The rational use of the functional techniques described in this chapter might lead to a better understanding and evaluation of the lymphatic system in oncologic patients routine clinical practice.