title: Pelvic normal tissue contouring guidelines for radiation therapy: a Radiation Therapy Oncology Group consensus panel atlas.
abstract: OBJECTIVE
  To define a male and female pelvic normal tissue contouring atlas for Radiation Therapy Oncology Group (RTOG) trials.
  
  
  METHODS
  One male pelvis computed tomography (CT) data set and one female pelvis CT data set were shared via the Image-Guided Therapy QA Center. A total of 16 radiation oncologists participated. The following organs at risk were contoured in both CT sets: anus, anorectum, rectum (gastrointestinal and genitourinary definitions), bowel NOS (not otherwise specified), small bowel, large bowel, and proximal femurs. The following were contoured in the male set only: bladder, prostate, seminal vesicles, and penile bulb. The following were contoured in the female set only: uterus, cervix, and ovaries. A computer program used the binomial distribution to generate 95% group consensus contours. These contours and definitions were then reviewed by the group and modified.
  
  
  RESULTS
  The panel achieved consensus definitions for pelvic normal tissue contouring in RTOG trials with these standardized names: Rectum, AnoRectum, SmallBowel, Colon, BowelBag, Bladder, UteroCervix, Adnexa_R, Adnexa_L, Prostate, SeminalVesc, PenileBulb, Femur_R, and Femur_L. Two additional normal structures whose purpose is to serve as targets in anal and rectal cancer were defined: AnoRectumSig and Mesorectum. Detailed target volume contouring guidelines and images are discussed.
  
  
  CONCLUSIONS
  Consensus guidelines for pelvic normal tissue contouring were reached and are available as a CT image atlas on the RTOG Web site. This will allow uniformity in defining normal tissues for clinical trials delivering pelvic radiation and will facilitate future normal tissue complication research.
authors.affiliation: Department of Radiation Oncology, Washington University School of Medicine, St Louis, MO 63110-6311, USA. hgay@radonc.wustl.edu
authors.forename: Hiram A
authors.initials: HA
authors.lastname: Gay
authors.forename: H Joseph
authors.initials: HJ
authors.lastname: Barthold
authors.forename: Elizabeth
authors.initials: E
authors.lastname: O'Meara
authors.forename: Walter R
authors.initials: WR
authors.lastname: Bosch
authors.forename: Issam
authors.initials: I
authors.lastname: El Naqa
authors.forename: Rawan
authors.initials: R
authors.lastname: Al-Lozi
authors.forename: Seth A
authors.initials: SA
authors.lastname: Rosenthal
authors.forename: Colleen
authors.initials: C
authors.lastname: Lawton
authors.forename: W Robert
authors.initials: WR
authors.lastname: Lee
authors.forename: Howard
authors.initials: H
authors.lastname: Sandler
authors.forename: Anthony
authors.initials: A
authors.lastname: Zietman
authors.forename: Robert
authors.initials: R
authors.lastname: Myerson
authors.forename: Laura A
authors.initials: LA
authors.lastname: Dawson
authors.forename: Christopher
authors.initials: C
authors.lastname: Willett
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Kachnic
authors.forename: Anuja
authors.initials: A
authors.lastname: Jhingran
authors.forename: Lorraine
authors.initials: L
authors.lastname: Portelance
authors.forename: Janice
authors.initials: J
authors.lastname: Ryu
authors.forename: William
authors.initials: W
authors.lastname: Small
authors.forename: David
authors.initials: D
authors.lastname: Gaffney
authors.forename: Akila N
authors.initials: AN
authors.lastname: Viswanathan
authors.forename: Jeff M
authors.initials: JM
authors.lastname: Michalski
mesh_terms: D000290:Adnexa Uteri; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging; D006801:Humans; D007422:Intestines / Q000000981:diagnostic imaging; D008297:Male; D008488:Medical Illustration; D058958:Organs at Risk / Q000000981:diagnostic imaging*; D010053:Ovary / Q000000981:diagnostic imaging; D010388:Pelvis / Q000000981:diagnostic imaging*; D010413:Penis / Q000000981:diagnostic imaging; D011467:Prostate / Q000000981:diagnostic imaging; D018787:Radiation Oncology / Q000592:standards*; D011859:Radiography; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods / Q000592:standards*; D061089:Radiotherapy, Image-Guided / Q000592:standards*; D012737:Sex Factors; D001743:Urinary Bladder / Q000000981:diagnostic imaging; D014599:Uterus