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1

FEMALE PELVIS Normal Tissue

RTOG Consensus Contouring GuidelinesHiram A. Gay, M.D., H. Joseph Barthold, M.D., Elizabeth OMeara, C.M.D., Walter R. Bosch, Ph.D.,

Issam El Naqa, Ph.D., Rawan Al-Lozi, Seth A. Rosenthal, M.D., Colleen Lawton, M.D., F.A.C.R.,

W. Robert Lee, M.D., Howard Sandler, M.D., Anthony Zietman, M.D., Robert Myerson, M.D., PH.D.,

Laura A. Dawson, M.D., Christopher Willett, M.D., Lisa A. Kachnic, M.D., Anuja Jhingran, M.D.,

Lorraine Portelance, M.D., Janice Ryu, M.D., William Small, Jr., M.D., David Gaffney, M.D., Ph.D.,

Akila N. Viswanathan, M.D., M.P.H, and Jeff M. Michalski, M.D.

Supported by grants from the National Cancer Institute, CA21661, CA32115, and CA37422

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2

Organ Standardized

TPS Name

Tumor

Category

Consensus Definition

anus +

rectum

AnoRect um GYN Inferiorly from the anal verge as marked with a radiopaque marker at the

time of simulation. Contouring ends superiorly before the rectum loses itsround shape in the axial plane and connects anteriorly with the sigmoid. The

AnoRectum is used with the Sigmoid and BowelBag.

sigmoid Si gmoi d GYN Bowel continuing where the AnoRectum contour ended. Stops prior toconnecting to the ascending colon laterally. Contoured when a brachytherapy

applicator rests in the uterus. Any sigmoid adjacent or above the uterus or a

brachytherapy applicator should be contoured.

bowel bag Bowel Bag GYN * Inferiorly from the most inferior small or large bowel loop, or above theRectum (GU) or AnoRectum (GYN), whichever is most inferior. If whenfollowing the bowel loop rule the Rectum or AnoRectum is present in that

axial slice, it should be included as part of the bag; otherwise it should be

excluded.

Tips: Contour the abdominal contents excluding muscle and bones. Contour

every other slice when the contour is not changing rapidly, and interpolate

and edit as necessary. Finally, subtract any overlapping non-GI normal

structures. If the TPS does not allow subtraction leave as is.

*Stop contouring the BowelBag, SmallBowel, and Colon 1 cm above PTV for most coplanar beam plans, but the

choice will depend on the treatment technique. Stop these PTVs at distances much greater than 1 cm for non-coplanar

beam plans depending on the beam angle and path. Tomotherapy plans will require stopping from 1 to 5 cm above the

PTV, depending on the selected field size, which is often 2.5 cm.

Abbreviations: TPS = treatment planning software

GYN

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3

Organ Standardized

TPS Name

Tumor

Category

Consensus Definition

bladder Bl adder GYN, GI Inferiorly from its base, and superiorly to the dome

uterus +

cervixUt er oCer vi x GYN The uterus and cervix as one structure. Tip: Fuse with MRI to help identify

it.

ovaries +

fallopian

tubes

Adnexa_RAdnexa_L

GYN Right and left ovary and fallopian tube. Tip: Fuse with MRI to help identify

these. Refer to the article by Olson et al. PubMed ID: 1609137

proximal

femurs

Femur _RFemur_L

GYN, GI The proximal femur inferiorly from the lowest level of the ischial

tuberosities (right or left) and superiorly to the top of the ball of the femur,

including the trochanters.

Tips: Auto-contouring threshold parameters with bone can facilitate this

process, but requires editing any auto-contouring artifacts.

GYN/GI

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4

Organ Standardized

TPS Name

Tumor

Category

Consensus Definition

small bowel Smal l Bowel GI * In order to distinguish from large bowel, the use of oral contrast is

encouraged. After administration of contrast (e.g. 3 oz gastrograffin and 3oz water/barium mixture) 30 minutes prior to scanning, the small bowel

can be outlined as loops containing contrast.

colon Col on GI * Large bowel continuing where the AnoRectumSig contour ended.Depending on the volume treated, this will include portions or all of the

ascending, transverse, descending and sigmoid colon.

*Stop contouring the BowelBag, SmallBowel, and Colon 1 cm above PTV for most coplanar beam plans, but the choicewill depend on the treatment technique. Stop these PTVs at distances much greater than 1 cm for non-coplanar beam

plans depending on the beam angle and path. Tomotherapy plans will require stopping from 1 to 5 cm above the PTV,

depending on the selected field size, which is often 2.5 cm.

GI

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5

Organ Standardized

TPS Name

Tumor

Category

Consensus Definition

anus +

rectum +

rectosigmoid

(target)

AnoRect umSi g GI Target structure. Inferiorly from the anal verge as marked with aradiopaque marker at time of simulation. Contouring ends superiorly at

the rectosigmoid flexure after the mesorectum disappears. The

AnoRectumSig is used with the Small Bowel and Colon.

mesorectum

(target)

Mesor ect um GI Target structure for anal and rectal cancer. The rectum inferiorly belowwhere the mesorectal fat disappears, and continuing superiorly and

encompassing the mesorectal fat until the mesorectal fascia disappears.

For these entities, the AnoRectoSig (anus + rectum + rectosigmoid),

unlike the rest of the alimentary canal, is NOT an avoidance structure.

In cases where it is difficult to visualize the mesorectum, the

anatomical borders of the mesorectum include: cranial, the level of the

recto-sigmoid junction; caudal, the anorectal junction defined by where

the levator muscles fuse with the external sphincter muscles (or where

the mesorectal fat/space can no longer be seen tapering inferiorly);

posterior, pre-sacral space; anterior, GU/GYN organs with an internal

margin of 10 mm to the anterior mesorectal border on the axial slicesof the bladder to account for bladder volume variation on this

boundary; lateral-medial edge of the levator ani in the lower pelvis and

pelvic brim in upper (excluding any non-target muscle).

Tip: Adjusting the windowing level may facilitate visualizing the

mesorectum.

GI - target

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Sagittal

Small Bowel

AnoRectumSig

Colon

UteroCervix

Bladder

Sigmoid

AnoRectum

BowelBag

UteroCervix

Bladder 6

Contour BowelBag, Colon and SmallBowel the

recommended cm above PTV, not necessarily this high

subtract any

overlappingnon-GI

normal

structures

from

BowelBag

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Coronal

Sigmoid

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

7

Any sigmoid adjacent

or above the uterus or

a brachytherapy

applicator should becontoured.

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

Axial

8

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

9

It is an excellent habit to always use the standardized nomenclature,

even if the patient is not in a protocol

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

10

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

A radiopaque marker would

have helped better identify the

anal verge

11

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

12

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

13

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

14

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

15

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

lowest level of ischial

tuberosities, this is where

Femur_L and Femur_R start

16

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

17

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

18

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

19

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

20

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

21

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

22

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

23

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

24

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

25

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

26

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

27

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

28

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

30

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

31

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

32

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

33

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

34

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

35

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

36

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

38

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

39

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

40

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

41

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

42

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

43

this is also part of Femur_L

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

44

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

46

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

47

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

48

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

49

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

50

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

51

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

52

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

53

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

54

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

55

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

56

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

57

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

58

BowelBag starts Inferiorly

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

59

from the most inferior small

or large bowel loop, or

above the Rectum (GU) or

AnoRectum (GYN),

whichever is most inferior. In

this case the large bowel

(see Colon below) is most

inferior.

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

AnoRectum stops here

since this is the last cut ithas a round shape

60

If the AnoRectum (GYN) or

Rectum (GU) is present in a

BowelBag axial slice, it

should be included as part of

the bag; otherwise it should

be excluded.

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

rectum becomes

elongated as it connects

anteriorly with the

rectosigmoid

61

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

62

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_LFemur_R

Adnexa_R

Adnexa_L

Bladder

UteroCervix, Bladder,

Adnexa_R, and Adnexa_L

excluded from BowelBag

63

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GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

Any Sigmoid adjacent or

above the uterus or a

brachytherapy applicator

should be contoured

64

7/22/2019 Female Pelvis Normal Tissue Rtog

65/129

GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

65

7/22/2019 Female Pelvis Normal Tissue Rtog

66/129

GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

66

7/22/2019 Female Pelvis Normal Tissue Rtog

67/129

7/22/2019 Female Pelvis Normal Tissue Rtog

68/129

GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

68

7/22/2019 Female Pelvis Normal Tissue Rtog

69/129

GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

69

7/22/2019 Female Pelvis Normal Tissue Rtog

70/129

GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

70

7/22/2019 Female Pelvis Normal Tissue Rtog

71/129

GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

71

G

7/22/2019 Female Pelvis Normal Tissue Rtog

72/129

GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

72

GYN

7/22/2019 Female Pelvis Normal Tissue Rtog

73/129

GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

UteroCervix

Bladder

UteroCervix

73

GYN

7/22/2019 Female Pelvis Normal Tissue Rtog

74/129

GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

74

GYN

7/22/2019 Female Pelvis Normal Tissue Rtog

75/129

GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

oral contrast would have

helped distinguish the small

bowel from the colon

75

GYN Stop contouring Sigmoid

7/22/2019 Female Pelvis Normal Tissue Rtog

76/129

GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

Stop contouring Sigmoid

prior to connecting to the

ascending colon laterally

76

GYN

7/22/2019 Female Pelvis Normal Tissue Rtog

77/129

GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

77

GYN:

7/22/2019 Female Pelvis Normal Tissue Rtog

78/129

GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

78

GYN:

7/22/2019 Female Pelvis Normal Tissue Rtog

79/129

GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

79

GYN:The BowelBag is bounded by the

7/22/2019 Female Pelvis Normal Tissue Rtog

80/129

GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

muscles and bone.

80

GYN:

7/22/2019 Female Pelvis Normal Tissue Rtog

81/129

GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

81

GYN:

7/22/2019 Female Pelvis Normal Tissue Rtog

82/129

GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

Ascending Colon

Descending Colon

82

GYN:

7/22/2019 Female Pelvis Normal Tissue Rtog

83/129

GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

83

GYN:

7/22/2019 Female Pelvis Normal Tissue Rtog

84/129

GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

84

GYN:

7/22/2019 Female Pelvis Normal Tissue Rtog

85/129

GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

85

GYN:

7/22/2019 Female Pelvis Normal Tissue Rtog

86/129

GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

86

GYN:

7/22/2019 Female Pelvis Normal Tissue Rtog

87/129

GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

87

GYN:

7/22/2019 Female Pelvis Normal Tissue Rtog

88/129

GI:

Small Bowel

AnoRectumSig

Colon

GYN:

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

88

GYN:

7/22/2019 Female Pelvis Normal Tissue Rtog

89/129

GI:

Small Bowel

AnoRectumSig

Colon

G

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

89

GYN:

7/22/2019 Female Pelvis Normal Tissue Rtog

90/129

GI:

Small Bowel

AnoRectumSig

Colon

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

90

GYN:

7/22/2019 Female Pelvis Normal Tissue Rtog

91/129

GI:

Small Bowel

AnoRectumSig

Colon

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

91

GYN:

7/22/2019 Female Pelvis Normal Tissue Rtog

92/129

GI:

Small Bowel

AnoRectumSig

Colon

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

92

GYN:

7/22/2019 Female Pelvis Normal Tissue Rtog

93/129

GI:

Small Bowel

AnoRectumSig

Colon

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

93

GYN:

7/22/2019 Female Pelvis Normal Tissue Rtog

94/129

GI:

Small Bowel

AnoRectumSig

Colon

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

94

GYN:

7/22/2019 Female Pelvis Normal Tissue Rtog

95/129

GI:

Small Bowel

AnoRectumSig

Colon

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

95

GYN:

7/22/2019 Female Pelvis Normal Tissue Rtog

96/129

GI:

Small Bowel

AnoRectumSig

Colon

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

96

GYN:

7/22/2019 Female Pelvis Normal Tissue Rtog

97/129

GI:

Small Bowel

AnoRectumSig

Colon

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

97

GYN:

7/22/2019 Female Pelvis Normal Tissue Rtog

98/129

GI:

Small Bowel

AnoRectumSig

Colon

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

98

GYN:

7/22/2019 Female Pelvis Normal Tissue Rtog

99/129

GI:

Small Bowel

AnoRectumSig

Colon

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

99

GYN:

7/22/2019 Female Pelvis Normal Tissue Rtog

100/129

GI:

Small Bowel

AnoRectumSig

Colon

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

100

GYN:

7/22/2019 Female Pelvis Normal Tissue Rtog

101/129

GI:

Small Bowel

AnoRectumSig

Colon

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

101

GYN:

7/22/2019 Female Pelvis Normal Tissue Rtog

102/129

GI:

Small Bowel

AnoRectumSig

Colon

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

102

GYN:

d

7/22/2019 Female Pelvis Normal Tissue Rtog

103/129

GI:

Small Bowel

AnoRectumSig

Colon

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

103

GYN:

Si id

7/22/2019 Female Pelvis Normal Tissue Rtog

104/129

GI:

Small Bowel

AnoRectumSig

Colon

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_R

Adnexa_R

Adnexa_L

Bladder

104

GYN:

Si id

7/22/2019 Female Pelvis Normal Tissue Rtog

105/129

GI:

Small Bowel

AnoRectumSig

Colon

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_RAdnexa_R

Adnexa_L

Bladder

105

7/22/2019 Female Pelvis Normal Tissue Rtog

106/129

GYN:

Si id

7/22/2019 Female Pelvis Normal Tissue Rtog

107/129

GI:

Small Bowel

AnoRectumSig

Colon

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_RAdnexa_R

Adnexa_L

Bladder

107

GYN:

Sigmoid

7/22/2019 Female Pelvis Normal Tissue Rtog

108/129

GI:

Small Bowel

AnoRectumSig

Colon

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_RAdnexa_R

Adnexa_L

Bladder

Transverse Colon

108

GYN:

Sigmoid

7/22/2019 Female Pelvis Normal Tissue Rtog

109/129

GI:

Small Bowel

AnoRectumSig

Colon

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_RAdnexa_R

Adnexa_L

Bladder

109

GYN:

Sigmoid

7/22/2019 Female Pelvis Normal Tissue Rtog

110/129

GI:

Small Bowel

AnoRectumSig

Colon

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_RAdnexa_R

Adnexa_L

Bladder

110

GYN:

Sigmoid

7/22/2019 Female Pelvis Normal Tissue Rtog

111/129

GI:

Small Bowel

AnoRectumSig

Colon

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_RAdnexa_R

Adnexa_L

Bladder

111

GYN:

Sigmoid

7/22/2019 Female Pelvis Normal Tissue Rtog

112/129

GI:

Small Bowel

AnoRectumSig

Colon

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_RAdnexa_R

Adnexa_L

Bladder

112

GYN:

Sigmoid

7/22/2019 Female Pelvis Normal Tissue Rtog

113/129

GI:

Small Bowel

AnoRectumSig

Colon

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_RAdnexa_R

Adnexa_L

Bladder

113

GYN:

Sigmoid

7/22/2019 Female Pelvis Normal Tissue Rtog

114/129

GI:

Small Bowel

AnoRectumSig

Colon

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_RAdnexa_R

Adnexa_L

Bladder

114

GYN:

Sigmoid

7/22/2019 Female Pelvis Normal Tissue Rtog

115/129

GI:

Small Bowel

AnoRectumSig

Colon

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_RAdnexa_R

Adnexa_L

Bladder

115

GYN:

Sigmoid

7/22/2019 Female Pelvis Normal Tissue Rtog

116/129

GI:

Small Bowel

AnoRectumSig

Colon

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_RAdnexa_R

Adnexa_L

Bladder

116

GYN:

Sigmoid

7/22/2019 Female Pelvis Normal Tissue Rtog

117/129

GI:

Small Bowel

AnoRectumSig

Colon

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_RAdnexa_R

Adnexa_L

Bladder

117

GYN:

Sigmoid

7/22/2019 Female Pelvis Normal Tissue Rtog

118/129

GI:

Small Bowel

AnoRectumSig

Colon

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_RAdnexa_R

Adnexa_L

Bladder

118

GYN:

Sigmoid

7/22/2019 Female Pelvis Normal Tissue Rtog

119/129

GI:

Small Bowel

AnoRectumSig

Colon

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_RAdnexa_R

Adnexa_L

Bladder

119

GYN:

Sigmoid

7/22/2019 Female Pelvis Normal Tissue Rtog

120/129

GI:

Small Bowel

AnoRectumSig

Colon

Sigmoid

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_RAdnexa_R

Adnexa_L

Bladder

120

GYN:

Sigmoid

7/22/2019 Female Pelvis Normal Tissue Rtog

121/129

GI:

Small Bowel

AnoRectumSig

Colon

g

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_RAdnexa_R

Adnexa_L

Bladder

121

GYN:

Sigmoid

7/22/2019 Female Pelvis Normal Tissue Rtog

122/129

GI:

Small Bowel

AnoRectumSig

Colon

g

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_RAdnexa_R

Adnexa_L

Bladder

122

7/22/2019 Female Pelvis Normal Tissue Rtog

123/129

GYN:

Sigmoid

7/22/2019 Female Pelvis Normal Tissue Rtog

124/129

GI:

Small Bowel

AnoRectumSig

Colon

g

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_RAdnexa_R

Adnexa_L

Bladder

124

GYN:

Sigmoid

7/22/2019 Female Pelvis Normal Tissue Rtog

125/129

GI:

Small Bowel

AnoRectumSig

Colon

g

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_RAdnexa_R

Adnexa_L

Bladder

125

GYN:

Sigmoid

7/22/2019 Female Pelvis Normal Tissue Rtog

126/129

GI:

Small Bowel

AnoRectumSig

Colon

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_RAdnexa_R

Adnexa_L

Bladder

126

GYN:

Sigmoid

7/22/2019 Female Pelvis Normal Tissue Rtog

127/129

GI:

Small Bowel

AnoRectumSig

Colon

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_RAdnexa_R

Adnexa_L

Bladder

127

GYN:

Sigmoid

7/22/2019 Female Pelvis Normal Tissue Rtog

128/129

GI:

Small Bowel

AnoRectumSig

Colon

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_RAdnexa_R

Adnexa_L

Bladder

128

GYN:

Sigmoid

7/22/2019 Female Pelvis Normal Tissue Rtog

129/129

GI:

Small Bowel

AnoRectum

BowelBag

GYN/GI:

UteroCervix

Femur_L

Femur_RAdnexa_R

Adnexa_L

Bladder