Volume 57, Issue 2, Pages (February 2010)

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Volume 57, Issue 2, Pages 205-211 (February 2010) A New Multimodality Technique Accurately Maps the Primary Lymphatic Landing Sites of the Bladder Beat Roth, Michael P. Wissmeyer, Pascal Zehnder, Frédéric D. Birkhäuser, George N. Thalmann, Thomas M. Krause, Urs E. Studer European Urology Volume 57, Issue 2, Pages 205-211 (February 2010) DOI: 10.1016/j.eururo.2009.10.026 Copyright © 2009 European Association of Urology Terms and Conditions

Fig. 1 Non-tumour-bearing injection sites of the bladder: (1) dome, (2) anterior wall, (3) right lateral wall, (4) left lateral wall, (5) posterior wall, (6) bladder neck/trigone. European Urology 2010 57, 205-211DOI: (10.1016/j.eururo.2009.10.026) Copyright © 2009 European Association of Urology Terms and Conditions

Fig. 2 Single-photon emission computed tomography: transverse, sagittal, and coronal fused image showing a radioactive node of the right external iliac region. European Urology 2010 57, 205-211DOI: (10.1016/j.eururo.2009.10.026) Copyright © 2009 European Association of Urology Terms and Conditions

Fig. 3 Boundaries of pelvic lymph node dissection subdivided into different regions and distribution of the corresponding technetium Tc 99m–positive lymph nodes: external iliac (Ia) distal and (Ib) proximal, obturator fossa (IIa) distal and (IIb) proximal, internal iliac (IIIa) distal and (IIIb) proximal, common iliac (IVa) distal and (IVb) proximal, (V) para-aortic/caval. European Urology 2010 57, 205-211DOI: (10.1016/j.eururo.2009.10.026) Copyright © 2009 European Association of Urology Terms and Conditions

Fig. 4 Primary lymphatic landing sites according to the different injection sites: (a) posterior wall (n=36), (b) dome (n=44), (c) anterior wall (n=54), (d) trigone/bladder neck (n=35), (e) right lateral wall (n=52), (f) left lateral wall (n=63). European Urology 2010 57, 205-211DOI: (10.1016/j.eururo.2009.10.026) Copyright © 2009 European Association of Urology Terms and Conditions

Fig. 5 Fusion image of the primary lymphatic landing sites (n=284 of 60 bladder sites) transferred from three-dimensional (3D) data sets and superimposed into an idealised anterior-posterior projection of the pelvis. All lymph nodes (LNs) depicted 3D reconstruction of single-photon emission computed tomography/computed tomography data sets and confirmed by surgery were subsequently transferred into a template projection of the pelvis. LNs are colour coded in relation to the vascular structures and ureters. European Urology 2010 57, 205-211DOI: (10.1016/j.eururo.2009.10.026) Copyright © 2009 European Association of Urology Terms and Conditions