Imaging-Based Treatment Adaptation in Radiation Oncology

Esther G. C. Troost*, Daniela Thorwarth, Wim J. G. Oyen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


In many tumor types, significant effort is being put into patient-tailored adaptation of treatment to improve outcome and preferably reduce toxicity. These opportunities first arose with the introduction of modern irradiation techniques (e.g., intensity-modulated radiotherapy) combined with functional imaging for more precise delineation of target volume. On the basis of functional CT, MRI, and PET results, radiation target volumes are altered during the course of treatment, or subvolumes inside the primary tumor are defined to enhance the dosing strategy. Moreover, the probability of complications to normal tissues is predicted using anatomic or functional imaging, such as in the use of CT or PET to predict radiation pneumonitis. Besides focusing, monitoring, and adapting photon therapy for solid tumors, PET also has a role in verifying proton-beam therapy. This article discusses the current state and remaining challenges of imaging-based treatment adaptation in radiation oncology.
Original languageEnglish
Pages (from-to)1922-1929
JournalJournal of Nuclear Medicine
Issue number12
Publication statusPublished - Dec 2015


  • PET/CT
  • functional CT
  • functional MRI
  • theranostics

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