{Reference Type}: Case Reports {Title}: Lipiodol injections for optimization of target volume delineation in a patient with a second tumor of the oropharynx: A case report. {Author}: Haderlein M;Merten R;Stojanovic A;Speer S;Scherl C;Fietkau R;Ott OJ; {Journal}: Strahlenther Onkol {Volume}: 191 {Issue}: 8 {Year}: Aug 2015 {Factor}: 4.033 {DOI}: 10.1007/s00066-015-0856-9 {Abstract}: BACKGROUND: Lipiodol injections were administered in the head and neck area to improve gross tumor volume (GTV) definition for small-volume re-irradiation of a 63-year-old previously irradiated patient with a second tumor of the oropharynx in the posterior wall with longitudinal ligament infiltration (cT4cN0cM0).
METHODS: The patient had dialysis-depending renal failure. On diagnostic computed tomography (CT), which was performed with intravenous contrast agent, the tumor in the oropharynx was not detectable. Because of dialysis-depending renal failure comorbidity, no contrast agent was applied in the planning CT and in the diagnostic magnetic resonance imaging (MRI) study. In each cross-sectional imaging study performed, the GTV, especially in craniocaudal extensions, was not safely delineable. Therefore, craniocaudal tumor margins were pharyngoscopically marked with Lipiodol injections, an iodine-containing contrast agent.
RESULTS: In a second planning CT, the GTV could be defined with the help of the Lipiodol marks and small-volume re-irradiation was performed. No Lipiodol-associated side effects occurred in the patient.
CONCLUSIONS: In the present case, the use of Lipiodol injections at the tumor margins facilitated the definition of the GTV.