Table 1.
Delineation instructions for CTV Breast and the lumpectomy cavity
| CTV Breast | Lumpectomy cavity | |
|---|---|---|
| Window/Level (WL); Window Width (WW) |
- Fixed: WL 0 Hounsfield Unit (HU) and WW of 500 HU for CT and variable WL and WW for MRI. |
- Fixed: WL 0 Hounsfield Unit (HU) and WW of 500 HU for CT and variable WL and WW for MRI. |
| - Change of WL and WW during delineation permitted for CT and MRI. |
- Change of WL and WW during delineation permitted for CT and MRI. |
|
| Appearance |
- The location of the marking wire, positioned around the palpable Glandular Breast Tissue (GBT), will be used as an aid for CTV Breast delineation. |
Appearance of contralateral breast (comparing with ipsilateral breast) serves as aid for LC delineation. |
| - The clinical target volume (CTV) breast was defined to comprise all GBT including fatty (involuted) lobes. | ||
| - Margin of the GBT is (ventrally) assumed to be situated 5 mm below the skin surface; in case of MRI the visible GBT fat is (ventrally) delineated as GBT margin. | ||
| - Delineation is performed on all CT or MRI slices that are judged to contain GBT. | ||
| - Appearance of the contralateral breast (by comparing with the ipsilateral breast) on CT or MR images. | ||
| - The preoperative mammographies and location of the palpable GBT marking wire, visible on CT or MRI, all will serve as an aid for GBT delineation. | ||
| Clips |
Surgical clips (if applicable) should all be included within the delineated GBT. |
All surgical clips (if applicable) should be included within delineated LC. |
| Seroma | Postoperative seroma/hematoma present in LC should be included within delineated GBT. | Postoperative seroma/hematoma present in LC should be included within delineated LC. |
Abbreviations:LC lumpectomy cavity, WL window level, WW window width, HU Hounsfield unit, MRI magnetic resonance imaging, CT computed tomography.