CPB Ljubljana 2018 course book

GEC-ESTRO Recommendations for APBI PTV Definition After Closed Cavity Surgery

Seven steps for target delineation after closed cavity surgery: 1. CT with radiopaque markers in the skin scar and areola 2. Delineation of clips (relevant and irrelevant) 3. Delineation of surgical bed – whole surgical scar (WS) inside breast if visible. 4. Delineation of ImTV (Imaging correlated Target Volume) regarding distance from skin and chest. 5. Delineation of ETB (Estimated Tumour Bed) 6. Delineation of CTV (Clinical Target Volume) ETB+ margin, excluding 5-10mm from skin and chest wall. CTV must include relevant clips, relevant WS, and ImTV.

7. Delineation of PTV (Planning Target Volume) if needed in big breasts or bad defined ETB