A Review of Advances in Lung Function Imaging and Its Applications for Functional Lung Avoidance in Radiation Therapy

Lung function imaging, with a specific focus on quantifying ventilation and perfusion, has gained increasing recognition within the field of functional lung avoidance radiation therapy (FLART), a technique that incorporates functional information to minimize radiation exposure to healthy lung tissue. This review critically analyzes multiple categories of clinical imaging modalities, including nuclear medicine imaging, computed tomography, and magnetic resonance imaging, which can assess the spatial distribution of lung functions. Each modality presents unique strengths in providing valuable information for FLART, yet they also have their limitations, which are detailed in this review. Furthermore, we discuss the current challenges limiting the broader implementation of lung function imaging and FLART in clinical practice. Future research directions and potential solutions are also outlined, to enable lung function imaging to play a more significant role in FLART, leading to personalized lung cancer management and improved patient outcomes.