CTV includes the GTV as well as the regions of direct, local subclinical spread of disease that must be treated. The CTV often has a high tumor cell density nearest the GTV with decreasing density toward the periphery. The CTV volumes may not contain demonstrable tumor but are considered at risk, such as regional lymph nodes and their volumes, for subclinical spread.
Bibliographic reference: Fisher, B. and Daugherty, L. (2013). C. In: L. Brady and T. Yaeger, ed., Encyclopedia of Radiation Oncology, 1st ed. Springer-Verlag Berlin Heidelberg, pp.77-154.
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