AROI-ESTRO GYN Teaching Course

Initial CTV-T: LR CTV-T

initial

Parametrium = the lateral extension of the uterine subserous connective tissue into the broad ligament

Primary CTV:

round ligament

bowel loop

• GTV • Cervix • Parametria • Uterus • Upper Vagina • Involved organs

Nodal CTV:

• lymph-nodes and draining areas

www.contourpoint.com

Anatomical boundaries Anteriorly

Posterior wall of bladder/bowel loops or posterior border of external iliac vessel

Posteriorly Laterally Superiorly Inferiorly

Uterosacral ligaments and mesorectal fascia

Medial border of internal obturator muscle/ pelvic sidewall

Top of fallopian tube/ broad ligament

Depending on vaginal tumor extension, pelvic floor