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Target Volume Delineation for Conformal and by Nancy Y. Lee, Nadeem Riaz, Jiade J. Lu

By Nancy Y. Lee, Nadeem Riaz, Jiade J. Lu

This textbook is designed to aid the busy radiation oncologist to correctly and optimistically delineate tumor volumes for conformal radiation treatment (including IMRT). The ebook presents an atlas of scientific objective volumes (CTVs) for more often than not encountered cancers, with every one bankruptcy illustrating CTV delineation on a slice-by-slice foundation, on making plans CT pictures. universal anatomic variations for every tumor are represented in person illustrations, with annotations highlighting changes in insurance. The anatomy of every web site and styles of lymphatic drainage are mentioned, and their impact at the layout of CTVs is defined intimately. usage of different imaging modalities, together with MRI, to delineate volumes is highlighted. Key info of simulation and making plans are in short reviewed. even supposing the emphasis is on track quantity delineation for conformal suggestions, info is usually supplied on traditional radiation box setup and layout while IMRT isn't really suitable.

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Extra info for Target Volume Delineation for Conformal and Intensity-Modulated Radiation Therapy

Example text

Base of tongue tumors that are superficial and not apparent GTV70 on imaging) and imaging Neck nodes: all suspicious (>1 cm, necrotic, enhancing, or FDG avid) lymph nodes. Borderline suspicious lymph nodes may be treated to an intermediate dose (66 Gy in 33 fractions) Typically same as GTV70 (no added margin). 4 should encompass GTV + minimum 1 cm margin while respecting anatomical barriers to spread, including bone, air, and skin Neck nodes – should include the at-risk lymphatic areas in the node-positive neck: Levels II–IV Lateral retropharyngeal lymph nodes up to skull base/jugular foramen High level II/retrostyloid space (see Fig.

The high-risk CTV60 is shown in green and CTV60: Cover the postop bed including scar covers the entire tongue and ipsilateral levels I–IV. Even with small, well-lateralized tumors, the entire tongue is at risk of microscopic tumor involvement, especially when there is evidence of invasive islands. If the tumor is located posteriorly, coverage of the ipsilateral tonsil can be considered. The low-risk CTV54, shown in blue, encompasses the contralateral levels IB–IV. A low anterior neck field was used to treat below the level of the arytenoids 38 Fig.

The high-risk CTV66 is shown in red and includes the region where close margins were identified. The highrisk CTV60 is shown in green and covers the entire tongue and all postoperative changes, including the flap reconstruction. In the absence Z. Kohutek et al. Recurrence in level IA of bone invasion, the mandible can be excluded from the CTV60. Note that the region near the ipsilateral parotid gland is well covered. The highrisk CTV60 within the neck includes the ipsilateral levels I–V, including level IA.

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