# Radiation Oncology/Contouring

Contouring See also: Anatomy

## CNS

Hippocampus
* Florida; 2009 PMID 19194118 -- "A radiation oncologist's guide to contouring the hippocampus." (Chera BS, Am J Clin Oncol. 2009 Feb;32(1):20-2.)
** Step-by-step guide to contouring the hippocampus on axial magnetic resonance images for radiation therapy treatment planning

## Head & Neck

* Please see the H&N anatomy page

## Regional breast lymph nodes

* Please see the axilla RT technique section

## Supraclavicular

Brachial plexus:
* Please see the Brachial plexus section
* Also see the section on this page Radiation_Oncology/Anatomy#Thorax
Breast Supraclavicular Target Volumes:
* See: SCV field section

## Thorax

General:
* PMID 20934273, 2010 (Article in press) -- "Consideration of Dose Limits for Organs at Risk of Thoracic Radiotherapy: Atlas for Lung, Proximal Bronchial Tree, Esophagus, Spinal Cord, Ribs, and Brachial Plexus." (Kong FM, Int J Radiat Oncol Biol Phys. 2010 Oct 7. [Epub ahead of print])
** Contouring atlas. Also includes other tips, pointers.
** Includes: Lung, proximal bronchial tree, esophagus, spinal cord, ribs, and brachial plexus

### Heart

* PMID 20421148, 2011 -- "Development and validation of a heart atlas to study cardiac exposure to radiation following treatment for breast cancer." (Feng M, Int J Radiat Oncol Biol Phys. 2011 Jan 1;79(1):10-8.)
** Contouring atlas. Includes contours of the whole heart, coronary vessels, chambers, and valves.

## Abdomen

* RTOG
** 2014 No PMID (journal not indexed) Abstract -- "Upper abdominal normal organ contouring guidelines and atlas: A Radiation Therapy Oncology Group consensus." (Jabbour SK, Pract Radiat Oncol 2014 Mar;4(2):82-89)

### Pancreas

Post-operative:
* RTOG
** 2012 PMID 22483737 "Radiation therapy oncology group consensus panel guidelines for the delineation of the clinical target volume in the postoperative treatment of pancreatic head cancer." (Goodman KA, Int J Radiat Oncol Biol Phys 2012 Jul 1;83(3):901-8.)

## Pelvis

Normal pelvic structures
* RTOG
** 2012 PMID 22483697 -- "Pelvic normal tissue contouring guidelines for radiation therapy: a radiation therapy oncology group consensus panel atlas." (Gay HA, Int J Radiat Oncol Biol Phys. 2012 Jul 1;83(3):e353-62.)
Pelvic lymph nodes:
* Toronto; 2009 PMID 19095369 -- "Pelvic lymph node topography for radiotherapy treatment planning from ferumoxtran-10 contrast-enhanced magnetic resonance imaging." (Dinniwell R, Int J Radiat Oncol Biol Phys. 2009 Jul 1;74(3):844-51.)
** Contouring guidelines.
* RTOG; 2008 PMID 18037584 -- "Consensus guidelines for delineation of clinical target volume for intensity-modulated pelvic radiotherapy in postoperative treatment of endometrial and cervical cancer." (Small W Jr, Int J Radiat Oncol Biol Phys. 2008 Jun 1;71(2):428-34. Epub 2007 Nov 26.)
** Consensus atlas of CTV for post-op RT of endometrial and cervical centers for IMRT
* St. Bartholomew (UK)
** 2007 PMID 17624745 -- "An atlas of the pelvic lymph node regions to aid radiotherapy target volume definition." (Taylor A, Clin Oncol (R Coll Radiol). 2007 Sep;19(7):542-50. Epub 2007 Jul 10.)
*** Development of a CT atlas
** 2005 PMID 16198509 — "Mapping pelvic lymph nodes: guidelines for delineation in intensity-modulated radiotherapy." Taylor A et al. Int J Radiat Oncol Biol Phys. 2005 Dec 1;63(5):1604-12.
*** Gynecologic malignancies. Used MRI with iron oxide particles to visualize lymph nodes. Determined the size of margins around vessels in order to include lymph nodes.
*** Gives common iliac, external iliac, internal iliac, obturator, and presacral.
*** Gives guidelines for pelvic nodal CTV delineation
* Portaluri (Italy), 2005 - PMID 15913911 — "A three-dimensional definition of nodal spaces on the basis of CT images showing enlarged nodes for pelvic radiotherapy." Portaluri M et al. Int J Radiat Oncol Biol Phys. 2005 Nov 15;63(4):1101-7.
** Defines anatomic boundaries for enlarged pelvic lymph nodes. Boundaries presented in table form. CT contours for each nodal group.
** Gives common iliac, external iliac, internal iliac, obturator, pudendal, deep inguinal, superficial inguinal, and presacral.
* Chao (Washington U.), 2002 - PMID 12419442 — "Lymphangiogram-assisted lymph node target delineation for patients with gynecologic malignancies." Chao KS et al. Int J Radiat Oncol Biol Phys. 2002 Nov 15;54(4):1147-52.
** Gynecologic malignancies. CT and lymphangiogram. Determined greatest distance from lymph node to the vessels.
** Did not include internal iliac (not usually visible on LAG)
** Conclusion: vessel expansion alone was not sufficient to cover the nodal areas fully and reasonably exclude normal tissue.
Lumbosacral Plexus:
* 2012 PMID 22342301 -- "Development of a Standardized Method for Contouring the Lumbosacral Plexus: A Preliminary Dosimetric Analysis of this Organ at Risk Among 15 Patients Treated With Intensity-Modulated Radiotherapy for Lower Gastrointestinal Cancers and the Incidence of Radiation-Induced Lumbosacral Plexopathy." (Yi SK, Int J Radiat Oncol Biol Phys. 2012 Oct 1;84(2):376-82.)

### Gyn cancers

* RTOG; 2008 PMID 18037584 -- "Consensus guidelines for delineation of clinical target volume for intensity-modulated pelvic radiotherapy in postoperative treatment of endometrial and cervical cancer." (Small W Jr, Int J Radiat Oncol Biol Phys. 2008 Jun 1;71(2):428-34. Epub 2007 Nov 26.)
** Consensus atlas of CTV for post-op RT of endometrial and cervical centers for IMRT

### Anal cancer

    see Radiation Oncology/Anal canal/Guidelines
* RTOG Atlas
** RTOG Anorectal Contouring Guidelines
** 2009 PMID 19117696 -- "Elective clinical target volumes for conformal therapy in anorectal cancer: a radiation therapy oncology group consensus panel contouring atlas." (Myerson RJ, Int J Radiat Oncol Biol Phys. 2009 Jul 1;74(3):824-30. Epub 2008 Dec 29.)
* AGITG: Australasian GI Trials Group
** 2012 PMID 22401917 -- "Australasian Gastrointestinal Trials Group (AGITG) Contouring Atlas and Planning Guidelines for Intensity-Modulated Radiotherapy in Anal Cancer." (Ng M, Int J Radiat Oncol Biol Phys. 2012 Aug 1;83(5):1455-62.)

## Groin

    See also contouring guidelines at #Anal cancer
Inguinal lymph nodes:
* For RT field design, see Radiation_Oncology/Vulva#Radiation_treatment_volumes (from PMID 8641909)
* UPMC;2012 No PMID (not indexed) Full text -- "Contouring inguinal and femoral nodes; how much margin is needed around the vessels?" (Kim CH, Practical Radiation Oncology 2012; 2(4):274-278.)