Radiotherapy and radiology: joint efforts for modern radiation planning and practice

With new irradiation techniques, the dose can be better matched to the contours of the tumour. The corollary is that greater precision is required. Recent intercomparison studies of treatment plans have emphasized the need to harmonise contouring practices. More of a consensus approach is based on using adaptive imaging modalities, expert group recommendations and automatic segmentation atlases, on harmonisation of dosimetric decisions through employing exhaustive nomograms for organs at risk, and on indexes for choosing optimal treatment plans. On another level, quality assurance and data pooling programmes have been set up, making use of DICOM-RT data transfer (image networks). The combination of several irradiation techniques (for example, intensity-modulated conformal radiation therapy plus CyberKnife(®) boost and re-irradiation), making it possible to irradiate tumours better, requires the cumulative doses to be recorded by dose summation software. Real awareness has been achieved in recent years as regards improving the quality of treatment, pooling data and harmonising practices.