Impact of the interplay between advances in imaging and radiotherapy on clinical care

Abstract

Advances in radiation oncology evolved in parallel with advances in multimodality imaging. Both in the treatment planning process and during the actual treatment delivery, anatomical and biological information has become a necessity, which relies heavily on information provided by medical imaging. New developments in multimodality imaging almost immediately initiated new applications in radiation oncology. Imaging has always played a key role in the development of radiotherapy, and in turn with the introduction of higher sophistication in treatment delivery, the requirements from multimodality imaging became more stringent and indeed critical. The future of radiotherapy lies in exploiting this synergy with imaging enabling high precision and adaptive treatment strategies and allowing personalized cancer therapy by taking into consideration the biological and anatomical variations of the tumor at the individual patient level (as opposed to the current practice in which treatment strategy is population oriented, based on stage of the disease and grade of the tumor). This fertile environment allows radiotherapy to explore new strategies in dose escalation, alternative fractionation and deliberate nonuniform dose distributions tailored to the natural heterogeneity of the tumor and surrounding tissues.