744 Terms and definitions to describe sonographic features of lymph nodes: consensus opinion from the vulvar international tumor analysis (VITA) group

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.