Current imaging paradigms in radiation oncology

Area of Science:

• Radiation Oncology
• Medical Imaging
• Molecular Biology

Background:

• Technological advancements in imaging have revolutionized image-guided radiation therapy.
• Anatomical imaging (CT, MRI) improved target delineation for 3D radiation treatment planning.
• A shift towards biological and molecular approaches in radiation oncology is emerging.

Purpose of the Study:

• To review the role of current imaging strategies in radiation oncology.
• To focus on functional imaging modalities for tumor staging and molecular profiling.
• To discuss the application of functional imaging in defining radiation target volumes and assessing therapeutic response.

Main Methods:

• Overview of anatomical imaging modalities (plain radiography, computed tomography, magnetic resonance imaging).
• Focus on functional imaging modalities (positron emission tomography, nuclear magnetic resonance spectroscopy, optical imaging).
• Discussion of molecular profiling aspects: cellular proliferation, apoptosis, angiogenesis, hypoxia, receptor status.

Main Results:

• Functional imaging offers a more biological and molecular approach to radiation oncology.
• These modalities aid in staging, molecular profiling, target volume definition, and response assessment.
• Key obstacles include imaging-pathological validation, optimal scan timing, tumor evolution, and lack of clinical outcome data.

Conclusions:

• Functional imaging is crucial for advancing radiation oncology beyond anatomical targeting.
• Further research and validation are needed to integrate functional imaging into routine clinical practice.
• Overcoming identified obstacles is essential for realizing the full potential of functional imaging-guided radiation therapy.