Cross-sectional nodal atlas: A tool for the definition of clinical target volumes in three-dimensional radiation therapy planning
Cross-sectional nodal atlas: A tool for the definition of clinical target volumes in three-dimensional radiation therapy planning
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DOI：
10.1148/radiology.211.3.r99jn40815
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发表时间：
1999-06-01
期刊：
影响因子：
19.7
通讯作者：
Gahbauer, R
中科院分区：
文献类型：
--
作者：
Martinez-Monge, R;Fernandes, PS;Gahbauer, R
当放射用于治疗目的时，辐射体积通常包括可检测到的肿瘤和被认为有转移扩散风险的解剖区域。国际放射单位和测量委员会第50(1)号报告将大体肿瘤体积(GTV)定义为肉眼可触及或可见或可显示的恶性生长的范围和位置。同一报告将临床靶体积(CTV)定义为包含可证明的GTV和或被认为(仅)包含特定概率水平的微观、亚临床扩展的体积。在临床实践中，CTV范围的确定是基于对每种特定疾病表现的传播模式的了解。其他可靠的信息可以从失效模式分析和尸检系列中获得。对于大多数肿瘤，CTV将包括一个或多个结节站，通常位于原发灶附近。传统上，这些节点站的位置和边界是在标准模拟设置期间参考解剖地标来确定的。因此，放射肿瘤学家已经接受了专门的培训，以便在标准的二维片上确定不同结节站的边界，特别是在正位和正位。随着三维(3D)虚拟临床靶点定义的出现，放射肿瘤学家面临着在横断面CT或磁共振图像上定义CTV的挑战。对这项新技术的陌生可能会使人们很难建立与已知空间参考的关联。目前的节点图谱旨在帮助放射肿瘤学家使用新的3D虚拟临床目标定义和治疗计划程序。
When radiation is used with curative intent, the radiation volume usually encompasses the detectable tumor and the anatomic areas thought to be at risk for metastatic spread. The International Commission on Radiation Units and Measurements Report No. 50 (1) defines gross tumor volume (GTV) as the gross palpable or visible or demonstrable extent and location of the malignant growth. The same report defines clinical target volume (CTV) as a volume that contains a demonstrable GTV and or is considered to contain (only) microscopic, subclinical extensions at a certain probability level. In clinical practice, the determination of the extent of the CTV is based on the knowledge of the patterns of spread for each specific disease presentation. Additional reliable information can be obtained from patterns-of-failure analysis and necropsy series. For most tumors, the CTV will encompass one or more nodal stations, usually near the primary lesion. Traditionally, the location and boundaries of these nodal stations have been established in reference to anatomic landmarks during the standard simulation setup. Therefore, the radiation oncologist has been specifically trained to determine the boundaries of the different nodal stations on standard two-dimensional radiographs, especially in the anteroposterior and posteroanterior views. With the advent of three-dimensional (3D) virtual clinical target definition, the radiation oncologist faces the challenge of defining the CTV on cross-sectional CT or magnetic resonance images. Unfamiliarity with this new technique can make correlations with the known spatial references difficult to establish. The present nodal atlas is intended to assist radiation oncologists who will use new 3D virtual clinical target definition and treatment planning programs.