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1、SpecialReportRafaelMartinez-Monge,MDCross-sectionalNodalAtlas:PatrickS.Fernandes,MDNilenduGupta,PhDAToolfortheDefinitionofReinhardGahbauer,MDClinicalTargetVolumesinIndexterms:Three-dimensionalRadiationComputedtomography(CT),three-dimensional,99.12917,199.92The
2、rapyPlanningLymphaticsystem,99.12917,99.92SpecialreportsTreatmentplanning,99.92Virtualthree-dimensionalclinicaltargetvolumedefinitionrequirestheidentificationRadiology1999;211:815±828ofareassuspectedofcontainingmicroscopicdisease(frequentlyrelatedtonodalAbbrev
3、iations:stations)onasetofcomputedtomographic(CT)images,ratherthanthetraditionalCTV5clinicaltargetvolumeapproachbasedonanatomiclandmarks.ThisatlasdisplaystheclinicallyrelevantGTV5grosstumorvolumenodalstationsandtheircorrelationwithnormallymphaticpathwaysonaseto
4、fCT3D5three-dimensionalimages.1FromtheDivisionofRadiationOncol-ogy,theArthurG.JamesCancerHospital,OhioStateUniversity,300WTenthAve,Columbus,OH43210.ReceivedJuly15,Whenradiationisusedwithcurativeintent,theradiationvolumeusuallyencompassesthe1998;revisionrequest
5、edAugust27;revisionreceivedOctober16;ac-detectabletumorandtheanatomicareasthoughttobeatriskformetastaticspread.TheceptedNovember23.Addressre-InternationalCommissiononRadiationUnitsandMeasurementsReportNo.50(1)definesprintrequeststoR.M.grosstumorvolume(GTV)asth
6、egrosspalpableorvisibleordemonstrableextentandrRSNA,1999locationofthemalignantgrowth.Thesamereportdefinesclinicaltargetvolume(CTV)asavolumethatcontainsademonstrableGTVand/orisconsideredtocontain(only)microscopic,subclinicalextensionsatacertainprobabilitylevel.
7、Inclinicalpractice,thedeterminationoftheextentoftheCTVisbasedontheknowledgeofthepatternsofspreadforeachspecificdiseasepresentation.Additionalreliableinformationcanbeobtainedfrompatterns-of-failureanalysisandnecropsyseries.Formosttumors,theCTVwillencompassoneor
8、morenodalstations,usuallyneartheprimarylesion.Traditionally,thelocationandboundariesofthesenodalstationshavebeenestablishedinreferencetoanatomiclandmarksduringthestandardsimulation
