Definition of radiation fields in Hodgkin lymphoma

Radiation field definitions^*

Involved-site radiation therapy (ISRT)

ISRT uses three-dimensional based simulation. The clinical target volume (CTV) encompasses the pre-chemotherapy volume but excludes initially uninvolved, displaced organs after disease regression. Fusion with pre-chemotherapy PET imaging can enhance the CTV definition. Expansion from CTV to internal target volume to planning target volume depends on internal motion and daily setup uncertainties.

Involved-node radiation therapy (INRT)

INRT can be regarded as a special case of ISRT wherein upfront PET-CT is acquired with the patient in the treatment position, using the same breathing instructions and immobilization devices that will be used later for RT.

Involved-field radiation therapy (IFRT), extended-field radiation therapy (EFRT), mantle field RT, inverted-Y field RT, and total nodal irradiation (TNI) were larger RT fields used in the past before availability of 3D-based planning, and they are no longer used in current practice.

* ISRT is the most commonly used RT field in North America since optimal pre-chemotherapy imaging in the RT position is typically not available.
PET: positron emission tomography; CT: computed tomography; RT: radiation therapy.

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Definition of radiation fields in Hodgkin lymphoma