Prostate Fossa Contouring Guide: Jill Gunther, MD Modified by The Econtour Team
Prostate Fossa Contouring Guide: Jill Gunther, MD Modified by The Econtour Team
Prostate Fossa Contouring Guide: Jill Gunther, MD Modified by The Econtour Team
Jill Gunther, MD
Modified by the eContour Team
You want to contour: Post-op Prostate
What now?
Bladder
Sacrum
Seminal vesicles
(proximal just means
segment close to
prostate)
Prostate
SagiDal view
Base of prostate
Seminal Vesicles
Apex of prostate
Coronal view
Bladder
Prostate
Axial view
Bladder
Femoral
heads
Prostate Rectum
Anatomical Borders of Post-Op CTV for
Prostate Cancer
Posterior edge
of pubic bone Obturator internus muscle
Levator ani
Posterior edge
of pubic bone
Obturator
internus
Green =
Bladder
minus CTV
Posterior 1-2cm
Obturator
bladder wall
internus*
Mesorectal
fascia/
rectal wall
Vas deferens may retract post-op;
include SV remnants if
pathologicaly involved
Include all surgical clips that are felt to
be in the prostate bed
(can have clips from nodal dissecJon)
When do I stop?
When do I stop?
SagiDal view 3-4cm above pubic
symphysis
8-12 mm
below vesico-
urethral
anastomosis
(just above
penile bulb)
Coronal view
DISCLAIMER: Each case is unique and requires decision making based on clinical judgment of the treaHng physician.
Some add more margin to guidelines with
consideraJon of specific paJent risk factors