食管癌GTV和CTV勾画的现状课件.ppt

* * * * * A-D为食管癌GTV最上端层面的图像，E-H为食管癌GTV最大层面的图像，I-L为食管癌GTV最下端层面图像。图C箭头处所示为DWI图像上GTV最上端病变，图D箭头处所示为融合图像上GTV最上端病变。图K箭头处所示为DWI图像上GTV最下端病变，图L箭头处所示为融合图像上GTV最下端病变。图E、图F箭头所示为标记点位置，两幅图显示为平乳头平面，为同一层面。 * * Let us to talk about Target Volume Delineation. CTVs is delineated as sub-clinical target volume, CTVnd is delineated as lymph regional of drainage, and the ITV is delineated as esophageal motion. * * The Japanese guideline was chosen from the Japanese Society for Esophageal Disease. The Chinese Guideline was chosen from the Beijing Society of Radiation Oncology. And the USA guideline was chosen from MD Anderson Cancer Center. * For the superior and inferior extension, Japanese guideline sets up 4cm margin, after 40-46Gy radiation，reduces to 2cm and boost to 60-70Gy; the Chinese guideline sets up 3cm as CTVs margin, and the American guideline is 5cm. For radial extension, Japan 0.5cm; China 0.5~0.8cm; USA 2cm. * For radial extension, Japan 0.5cm; China 0.5~0.8cm; USA 2cm. * * * * Our study results have been published in the red-journal this year. * * * * * * Let us to talk about Target Volume Delineation. CTVs is delineated as sub-clinical target volume, CTVnd is delineated as lymph regional of drainage, and the ITV is delineated as esophageal motion. * * According to the Japanese guideline a “T” type field (including supraclavicular node) will be given or “I” type field * We underwent a clinical study about …. * Let us to talk about Target Volume Delineation. CTVs is delineated as sub-clinical target volume, CTVnd is delineated as lymph regional of drainage, and the ITV is delineated as esophageal motion. * * We define the CTVs as: * We define the CTVs as: * We define the CTVs as: * We define the CTVs as: * This is the slogan of Beijing Olympic games, 北京大学第一医院指南 GTV 所有大体肿瘤：影像所见包括食管钡餐、CT、 PET 和临床获得的信息，以及食管/胃/十二指肠镜和超声内镜报告的病变距中切齿距离。 大于1cm的淋巴结，气管旁沟的任何大小的淋巴结。 CTVs: GTV + 3 cm， 大体肿瘤头脚方向外放3cm。 侧向外放0.5 cm，不超过解剖边界，除非有证据证实其受侵。 CTVnd 仅包括累及的区域淋巴结。 颈部病变要包括锁骨上淋巴结。 PTV CTV +0