胸部放射治疗中的危及器官图谱.pptVIP

胸部放射治疗中的危及器官（OARs）图谱Atlases for Organs at Risk (OARs) in Thoracic Radiation Therapy Outline of ContentAtlas for lung, esophagus, and spinal cordAtlas for brachial plexusAtlas for proximal bronchial treeAtlas for chest wall Atlas for pericardium, heart and great vessels (including normal pericardial recesses) RTOG 1106 Required OARsStructureDescriptionStructure definition and contouring instructionsLungLungs – PreGTV(composite of CT1GTV and PETMTV)Both lungs should be contoured using pulmonary windows. The right and left lungs can be contoured separately, but they should be considered as one structure for lung dosimetry. All inflated and collapsed, fibrotic and emphysematic lungs should be contoured, small vessels extending beyond the hilar regions should be included; however, pre GTV, hilars and trachea/main bronchus should not be included in this structure.HeartHeart PericardiumThe heart will be contoured along with the pericardial sac. The superior aspect (or base) will begin at the level of the inferior aspect of the pulmonary artery passing the midline and extend inferiorly to the apex of the heart.EsophagusEsophagusThe esophagus should be contoured from the beginning at the level just below the cricoid to its entrance to the stomach at GE junction. The esophagus will be contoured using mediastinal window/level on CT to correspond to the mucosal, submucosa, and all muscular layers out to the fatty adventitia.SpinalcordSpinal CanalThe spinal cord will be contoured based on the bony limits of the spinal canal. The spinal cord should be contoured starting at the level just below cricoid (base of skull for apex tumors) and continuing on every CT slice to the bottom of L2. Neuroformanines should not be included. BrachialplexBrachial PlexusThis is only required for patients with tumors of upper lobes. Only the ipsilateral brachialplex is required. This will include the spinal nerves exiting the neuroforamine from top of C5 to top of T2. In contrast to prior