title: Imaging-Based Treatment Adaptation in Radiation Oncology.
abstract: In many tumor types, significant effort is being put into patient-tailored adaptation of treatment to improve outcome and preferably reduce toxicity. These opportunities first arose with the introduction of modern irradiation techniques (e.g., intensity-modulated radiotherapy) combined with functional imaging for more precise delineation of target volume. On the basis of functional CT, MRI, and PET results, radiation target volumes are altered during the course of treatment, or subvolumes inside the primary tumor are defined to enhance the dosing strategy. Moreover, the probability of complications to normal tissues is predicted using anatomic or functional imaging, such as in the use of CT or PET to predict radiation pneumonitis. Besides focusing, monitoring, and adapting photon therapy for solid tumors, PET also has a role in verifying proton-beam therapy. This article discusses the current state and remaining challenges of imaging-based treatment adaptation in radiation oncology.
authors.affiliation: MAASTRO Clinic, GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands Institute of Radiooncology, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany esther.troost@uniklinikum-dresden.de.
authors.forename: Esther G C
authors.initials: EG
authors.lastname: Troost
authors.affiliation: Section for Biomedical Physics, Department of Radiation Oncology, Eberhard Karls University, Tübingen, Germany.
authors.forename: Daniela
authors.initials: D
authors.lastname: Thorwarth
authors.affiliation: Department of Radiology and Nuclear Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands; and Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, United Kingdom.
authors.forename: Wim J G
authors.initials: WJ
authors.lastname: Oyen
mesh_terms: D006801:Humans; D008279:Magnetic Resonance Imaging; D057054:Molecular Imaging / Q000379:methods; D009369:Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy*; D049268:Positron-Emission Tomography; D018787:Radiation Oncology / Q000639:trends*; D014057:Tomography, X-Ray Computed
keywords: PET/CT; functional CT; functional MRI; theranostics