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Definition of Target Volume and Organs at Risk. Biological Target Volume

  • Chapter
New Technologies in Radiation Oncology

Part of the book series: Medical Radiology ((Med Radiol Radiat Oncol))

13.5 Conclusion

Target volume definition is an interactive process. Based on radiological (and biological) imaging, the radiation oncologist has to outline the GTV, CTV, ITV, and PTV and BTV. In this process, a lot of medical and technological aspects have to be considered. The criteria for GTV, CTV, etc. definition are often not exactly standardised, and this leads, in many cases to variability between clinicians; however, exactly defined imaging criteria, imaging with high sensitivity and specificity for tumour tissue and special training could lead to a higher consensus in target volume delineation and, consequently, to lower differences between clinicians. It must be emphasised, however, that further verification studies and cost-benefit analyses are needed before biological target definition can become a stably integrated part of target volume definition.

The ICRU report 50 from 1993 and the ICRU report 62 from 1999 defining the anatomically based terms CTV, GTV and PTV must still be considered as the gold standard in radiation treatment planning; however, further advances in technology concerning signal resolution and development of new tracers with higher sensitivity and specificity will induce a shift of paradigms away from the anatomically based target volume definition towards biologically based treatment strategies. New concept and treatment strategies should be defined based on these new investigation methods, and the standards in radiation treatment planning — in a continuous, evolutionary process — will have to integrate new imaging methods in an attempt to finally achieve the ultimate goal of cancer cure.

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Authors and Affiliations

  1. Department of Radiation Oncology, Klinikum rechts der Isar, Technical University Munich, Ismaningerstrasse 22, 81675, Munich, Germany

    Anca-Ligia Grosu MD, Lisa D. Sprague PhD & Michael Molls MD

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  1. Anca-Ligia Grosu MD
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  2. Lisa D. Sprague PhD
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  3. Michael Molls MD
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  1. Abteilung Medizinische Physik in der Strahlentherapie, Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany

    Wolfgang Schlegel PhD (Professor) (Professor)

  2. Department of Radiation Oncology, Massachusetts General Hospital, 30,Fruit Street, Boston, MA, 02114, USA

    Thomas Bortfeld PhD (Professor) (Professor)

  3. Department of Radiation Oncology, Klinikum rechts der Isar Technical University Munich, Ismaningerstrasse 22, 81675, München, Germany

    Anca-Ligia Grosu MD (Privatdozent) (Privatdozent)

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Grosu, AL., Sprague, L.D., Molls, M. (2006). Definition of Target Volume and Organs at Risk. Biological Target Volume. In: Schlegel, W., Bortfeld, T., Grosu, AL. (eds) New Technologies in Radiation Oncology. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-29999-8_13

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  • DOI: https://doi.org/10.1007/3-540-29999-8_13

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