In intracavitary brachytherapy for cervical carcinoma, the classical Manchester system defines point A as:

• A At the junction of the upper and middle thirds of the vagina, 2 cm from the applicator surface
• B At the midpoint of the vaginal ovoids in the lateral fornix
• C 5 cm from the midline along the horizontal plane through the lower border of the sacroiliac joints
• D 2 cm superior to the external cervical os and 2 cm lateral to the midline of the uterus ✓

Explanation

Point D lies 2 cm above the external os and 2 cm lateral to the midline, corresponding roughly to the region where the uterine vessels cross the ureter, and it represents the target for prescribing dose to the paracervical tissues. Point B, 3 cm lateral to point D, approximates the obturator and pelvic sidewall nodes. The other descriptions do not correspond to any standard Manchester reference point.

Reference: Novak's Gynecology, 16th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.