Proposed definition of the vaginal cuff and paracolpium clinical target volume in postoperative uterine cervical cancer  Naoya Murakami, MD, PhD, Yoshiki.

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Proposed definition of the vaginal cuff and paracolpium clinical target volume in postoperative uterine cervical cancer  Naoya Murakami, MD, PhD, Yoshiki Norihisa, MD, PhD, Fumiaki Isohashi, MD, PhD, Keiko Murofushi, MD, PhD, Takuro Ariga, MD, PhD, Tomoyasu Kato, MD, PhD, Koji Inaba, MD, Hiroyuki Okamoto, PhD, Yoshinori Ito, MD, Takafumi Toita, MD, PhD, Jun Itami, MD, PhD  Practical Radiation Oncology  Volume 6, Issue 1, Pages 5-11 (January 2016) DOI: 10.1016/j.prro.2015.04.008 Copyright © 2016 American Society for Radiation Oncology Terms and Conditions

Figure 1 Schemata of preoperative and postoperative anatomic components of the female pelvic floor around the preoperative cervix (A), postoperative vaginal vault (B), mid vagina (C), and lower vagina (D). lig, ligament. Practical Radiation Oncology 2016 6, 5-11DOI: (10.1016/j.prro.2015.04.008) Copyright © 2016 American Society for Radiation Oncology Terms and Conditions

Figure 2 A schematic anatomy of the female pelvic floor. The levator ani consists of 4 muscles: puborectalis, pubococcygeus, iliococcygeus, and coccygeus muscle. Practical Radiation Oncology 2016 6, 5-11DOI: (10.1016/j.prro.2015.04.008) Copyright © 2016 American Society for Radiation Oncology Terms and Conditions

Figure 3 Representative magnetic resonance image of a patient who had undergone hysterectomy. (A) Level above the vaginal stump. Large white arrowhead indicates internal obturator muscle; small white arrow, iliococcygeus muscle; small black arrowhead, mesorectal fascia. (B) Level of the vaginal stump. Large white arrowhead indicates internal obturator muscle; small white arrow, iliococcygeus muscle. (C) Level of the bladder base. Large white arrowhead indicates internal obturator muscle; small arrow, pubococcygeus muscle. (D) Level below the bladder. Large white arrowhead indicates internal obturator muscle; large black arrowhead, puborectalis muscle. B, bladder; IRF, ischiorectal fossa; R, rectum; RPF, retropubic fat; V, vagina; U, urethra. Practical Radiation Oncology 2016 6, 5-11DOI: (10.1016/j.prro.2015.04.008) Copyright © 2016 American Society for Radiation Oncology Terms and Conditions

Figure 4 An example of the actual delineation for the vaginal cuff and paracolpium clinical target volume. The green line represents metallic markers inserted in the vaginal stump; yellow line, the vaginal cuff and paracolpium clinical target volume; pink line, the bladder; and brown line, the rectum. Practical Radiation Oncology 2016 6, 5-11DOI: (10.1016/j.prro.2015.04.008) Copyright © 2016 American Society for Radiation Oncology Terms and Conditions