Advanced Tumor Imaging and Image-Guided Radiation Therapy
Nina Mayr, Ph.D. (Professor and Chair of the Department of Radiation Oncology at the University of Washington)
With the rapid advancement in radiation therapy technologies including single- and multi-fraction stereotactic delivery therapy (SRT) as well as new radiation modalities, such as proton therapy, high-precision delivery of radiation therapy has become a widely available tool in many malignancies, and allows better protection of normal tissues and thereby radiation dose escalation to the tumor for better tumor control. The choice of imaging modalities and the use of imaging in radiation therapy planning require different paradigms than the imaging for diagnostic purposes, and are areas of evolving investigation.
The application of tumor imaging in radiation therapy for various cancers, including lung cancer, gynecologic cancer and neurologic tumors, and the role of multi-modality and functional imaging will be reviewed. Future perspectives will be discussed, including longitudinal imaging-monitoring and adaptive therapy. Novel applications of imaging as early outcome predictors and biomarkers of response will be discussed in gynecologic cancer. Pitfalls and future directions will be reviewed.