Table 4.
Width, Height and Thickness details for defining and delineating four categories of CTV-THR-CT based on CT at diagnosis & Pre BT MR and CT at BT (CT - Pre BT MRI and CTBT Environment).
Category of BT | Width | Height |
Thickness |
||
---|---|---|---|---|---|
Lateral | Superior | Inferior | Anterior | Posterior | |
| |||||
IBT | Lateral boundaries of cervix | Lower extent of cervical lip with vaginal applicator as surrogate | Outer surface of the cervix &/or uterus guided by Pre BT MR dimensions | Outer surface of the cervix &/or uterus guided by Pre BT MR dimensions | |
IIBT | Proximal parametrium defined by clinical/TRUS based NMD’s (if available) and guided by NMD’s on Pre-BT MR | Lower two thirds of utero-cervical dimensions | Include appropriate length of vaginal wall defined by clinical examination and with /without guidance of markers implanted and the Pre BT MR findings with few mm longitudinal and upto 2 cm circumferential safety margins | ||
To utilize TRUS based distances (if available) | To utilize TRUS based distances (if available) | ||||
IIIBT | Distal parametrium defined by clinical/TRUS based NMD’s (if available) and guided by NMD’s on Pre-BT MR$ | ||||
IVBT | Proximal /distal parametrium/Up to lateral pelvic wall defined by clinical/TRUS based NMD’s (if available) and guided by NMD’s on Pre-BT MR. | Length and circumference of vagina should not exceed vaginal disease at diagnosis | In addition to outer surface of the cervix &/or uterus to include the bladder wall/mucosae involved with 2 cm margins at least guided by Pre BT MR findings To utilize TRUS based distances (if available) |
In addition to outer surface of the cervix &/or uterus to include the rectal wall/mucosae involved with 2 cm margins at least guided by Pre BT MR findings To utilize TRUS based distances (if available) |