Primary CTV:
•
GTV
•
Cervix
•
Parametria
•
Uterus
•
Upper Vagina
•
Involved organs
Nodal CTV:
•
lymph-nodes and draining areas
www.contourpoint.combowel loop
round ligament
Initial CTV-T: LR CTV-T
initial
Parametrium = the lateral extension of the uterine subserous connective tissue into the broad ligament
Anatomical boundaries
Anteriorly
Posterior wall of bladder/bowel loops or posterior border of external iliac vessel
Posteriorly
Uterosacral ligaments and mesorectal fascia
Laterally
Medial border of internal obturator muscle/ pelvic sidewall
Superiorly
Top of fallopian tube/ broad ligament
Inferiorly
Depending on vaginal tumor extension, pelvic floor