Mahase Sean S, Wernicke A Gabriella, Nori Dattatreyudu, Parashar Bhupesh
College of Medicine, SUNY Downstate Medical Center, Brooklyn, NY 11203, USA.
Stich Radiation Center, Weill Cornell Medical College, New York, NY 10065, USA.
Discov Med. 2015 Mar;19(104):203-11.
The advent of functional imaging facilitates the acquisition of patient-specific tumor characteristics, including its metabolic state and regional oxygen tension. Recent advances promote incorporating this information with data obtained from current imaging techniques, such as MRI and CT, to manage various malignancies. Functional imaging's vital roles progressively evolved to include: aiding in diagnosis, improving radiation treatment planning, differentiating tumor volume from surrounding normal tissues which enables dose escalation to the former while improving sparing of the latter, adapting radiation therapy regimens according to a tumor's response to initial treatment, and assessing radiation therapy response and toxicity. This review explores functional imaging in radiation oncology in the context of these five applications, as well as its comparison to, and integration with, existing imaging modalities. In parallel with advances in functional imaging and understanding of tumor microbiology, the emergence of diverse tracers provides a plethora of options to distinguish and manage malignancies on the basis of specific metabolic processes and changing microenvironmental cues. Current limitations, potential concerns, and future innovations of functional imaging are also discussed.
功能成像的出现有助于获取患者特异性肿瘤特征，包括其代谢状态和局部氧张力。最近的进展推动将这些信息与从当前成像技术（如MRI和CT）获得的数据相结合，以管理各种恶性肿瘤。功能成像的重要作用逐渐演变为包括：辅助诊断、改善放射治疗计划、区分肿瘤体积与周围正常组织，从而在提高对后者的保护的同时，使前者的剂量增加、根据肿瘤对初始治疗的反应调整放射治疗方案，以及评估放射治疗反应和毒性。本综述在这五种应用的背景下探讨了放射肿瘤学中的功能成像，以及它与现有成像模式的比较和整合。随着功能成像的进展以及对肿瘤微生物学的理解，各种示踪剂的出现为基于特定代谢过程和不断变化的微环境线索来区分和管理恶性肿瘤提供了大量选择。还讨论了功能成像的当前局限性、潜在问题和未来创新。
