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Primary CTV:

GTV

Cervix

Parametria

Uterus

Upper Vagina

Involved organs

Nodal CTV:

lymph-nodes and draining areas

www.contourpoint.com

bowel 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