Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada.
Oncologist. 2010;15(4):338-49. doi: 10.1634/theoncologist.2009-S106.
An inherent goal of radiation therapy is to deliver enough dose to the tumor to eradicate all cancer cells or to palliate symptoms, while avoiding normal tissue injury. Imaging for cancer diagnosis, staging, treatment planning, and radiation targeting has been integrated in various ways to improve the chance of this occurring. A large spectrum of imaging strategies and technologies has evolved in parallel to advances in radiation delivery. The types of imaging can be categorized into offline imaging (outside the treatment room) and online imaging (inside the treatment room, conventionally termed image-guided radiation therapy). The direct integration of images in the radiotherapy planning process (physically or computationally) often entails trade-offs in imaging performance. Although such compromises may be acceptable given specific clinical objectives, general requirements for imaging performance are expected to increase as paradigms for radiation delivery evolve to address underlying biology and adapt to radiation responses. This paper reviews the integration of imaging and radiation oncology, and discusses challenges and opportunities for improving the practice of radiation oncology with imaging.
放射治疗的一个固有目标是向肿瘤提供足够的剂量，以消灭所有癌细胞或缓解症状，同时避免正常组织损伤。癌症诊断、分期、治疗计划和放射靶向的成像已经以各种方式进行了整合，以提高这种可能性。随着放射治疗的发展，一系列广泛的成像策略和技术也在不断发展。成像的类型可以分为离线成像（治疗室外）和在线成像（治疗室内，通常称为图像引导放射治疗）。在放射治疗计划过程中直接整合图像（物理上或计算上）通常需要在成像性能方面进行权衡。尽管鉴于特定的临床目标，这些妥协可能是可以接受的，但随着放射治疗的范例演变为解决潜在生物学问题并适应放射反应，预计对成像性能的一般要求将会提高。本文回顾了成像与肿瘤放射学的整合，并讨论了利用成像改善肿瘤放射学实践的挑战和机遇。
