An in-silico Comparison of Clinical Target Volume and Clinical Target Distribution for Skull Base Chordoma

Clinical target volume (CTV) is a traditional target delineation method used in radiotherapy. The concept has several limitations (such as binary conceptualisation, variability and uncertainty). More recently a continuous probabilistic concept—Clinical Target Distribution (CTD) has come into prominence, which addresses the above mentioned limitations. In this paper, we implemented CTD in the treatment planning system and compared CTV and CTD in the cases of skull base chordomas. Under the CTD concept we infer tumoral prescription dose, observe maximal OAR dose constraints and highlight the dose distribution advantages.