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GTV. CTV. ITV. PTV. Target Definitions. GTV. CTV. ITV-1. ITV-2. Avoid Large Free-breathing ITVs. Motion Control Goals. CTV about equal to ITV Possible with tumors away from influence of diaphragm (e.g., apical tumors)
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GTV CTV ITV PTV Target Definitions
GTV CTV ITV-1 ITV-2 Avoid Large Free-breathing ITVs
Motion Control Goals • CTV about equal to ITV • Possible with tumors away from influence of diaphragm (e.g., apical tumors) • tumors adherent to non-moving structure (e.g., posterior rib or spine) • Also, tumors may not move much in patients with very severe emphysema • If ITV significantly bigger than CTV, then must • Dampen motion with compression (easiest) • Use duty cycle maneuver (gating or breath hold) • Chase the tumor (must have accurate motion model)