title: PET/CT imaging-guided dose painting in radiation therapy.
abstract: Application of functional imaging to radiotherapy (RT) is a rapidly expanding field with the development of new modalities and techniques. Functional imaging of PET in conjunction with RT provides new avenues towards the clinical application of dose painting - a new RT strategy delivering optimized dose redistribution according to the functional imaging information to further improve tumour control. Two prototypical strategies of dose painting are reviewed: dose painting by contours (DPBC) and dose painting by numbers (DPBN). DPBN set a linear correlation of the boost dose and image intensity of this same voxel while homogeneous dose is given to the subvolume contoured by a threshold created in PET images in DPBC. Both comply with strict organs at risk (OAR) constraints and are alternatives for boosting subvolumes in clinical practice. This review focuses on the rationale, target validation, dose prescription verification and evaluation and recent clinical achievements in the field of integrating PET imaging into RT treatment planning. Further research is necessary in order to investigate unresolved problems in its routine clinical application thoroughly.
authors.affiliation: Department of Radiation Oncology, Key Laboratory of Radiation Oncology of Shandong Province, Shandong Cancer Hospital, Shandong University, Jinan, Shandong Province, China; Department of Oncology, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shanxi Province, China.
authors.forename: Xiaorong
authors.initials: X
authors.lastname: Shi
authors.affiliation: Department of Radiation Oncology, Key Laboratory of Radiation Oncology of Shandong Province, Shandong Cancer Hospital, Shandong University, Jinan, Shandong Province, China.
authors.forename: Xue
authors.initials: X
authors.lastname: Meng
authors.affiliation: Department of Radiation Oncology, Key Laboratory of Radiation Oncology of Shandong Province, Shandong Cancer Hospital, Shandong University, Jinan, Shandong Province, China.
authors.forename: Xindong
authors.initials: X
authors.lastname: Sun
authors.affiliation: Department of Radiation Oncology, Key Laboratory of Radiation Oncology of Shandong Province, Shandong Cancer Hospital, Shandong University, Jinan, Shandong Province, China.
authors.forename: Ligang
authors.initials: L
authors.lastname: Xing
authors.affiliation: Department of Radiation Oncology, Key Laboratory of Radiation Oncology of Shandong Province, Shandong Cancer Hospital, Shandong University, Jinan, Shandong Province, China. Electronic address: jn7984729@public.jn.sd.cn.
authors.forename: Jinming
authors.initials: J
authors.lastname: Yu
mesh_terms: D004307:Dose-Response Relationship, Radiation; D006801:Humans; D064847:Multimodal Imaging / Q000379:methods*; D009369:Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D049268:Positron-Emission Tomography / Q000379:methods*; D011829:Radiation Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D061089:Radiotherapy, Image-Guided / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Dose painting by contours; Dose painting by numbers; Functional imaging; RT treatment planning