Imaging Biomarkers in Radiotherapy

Area of Science:

• Radiotherapy research
• Medical imaging
• Biomarker development

Background:

• Medical imaging modalities like MRI, PET, and CT have evolved beyond anatomical guidance.
• Innovations include radiomics, artificial intelligence (AI), adaptive radiotherapy, and theranostics.
• These advancements enable biologically informed treatment planning and response assessment.

Purpose of the Study:

• To provide a comprehensive overview of imaging biomarkers in radiotherapy (RT).
• To synthesize clinical evidence on their application across disease sites.
• To examine challenges and propose a roadmap for clinical translation.

Main Methods:

• Review of technical foundations of imaging biomarkers in RT.
• Synthesis of functional and molecular imaging techniques.
• Analysis of data-driven analytic approaches and AI.

Main Results:

• Imaging biomarkers refine target delineation and guide dose painting.
• They predict and monitor treatment response for adaptive RT.
• Clinical evidence supports their role in personalized RT strategies.

Conclusions:

• Imaging biomarkers are central to advancing biologically adaptive and precision radiotherapy.
• Key challenges include standardization, validation, AI interpretability, and ethical considerations.
• A multi-stage roadmap is proposed for responsible and equitable clinical integration.