Open AccessChallenges and opportunities in patient‐specific, motion‐managed and PET/CT‐guided radiation therapy of lung cancer: review and perspective
Author(s) -
Bowen Stephen R,
Nyflot Matthew J,
Gensheimer Michael,
Hendrickson Kristi R G,
Kinahan Paul E,
Sandison George A,
Patel Shilpen A
Publication year - 2012
Publication title -
clinical and translational medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.125
H-Index - 1
ISSN - 2001-1326
DOI - 10.1186/2001-1326-1-18
Subject(s) - perspective (graphical) , medicine , lung cancer , radiation therapy , medical physics , cancer , radiology , oncology , artificial intelligence , computer science
The increasing interest in combined positron emission tomography (PET) and computed tomography (CT) to guide lung cancer radiation therapy planning has been well documented. Motion management strategies during treatment simulation PET/CT imaging and treatment delivery have been proposed to improve the precision and accuracy of radiotherapy. In light of these research advances, why has translation of motion‐managed PET/CT to clinical radiotherapy been slow and infrequent? Solutions to this problem are as complex as they are numerous, driven by large inter‐patient variability in tumor motion trajectories across a highly heterogeneous population. Such variation dictates a comprehensive and patient‐specific incorporation of motion management strategies into PET/CT‐guided radiotherapy rather than a one‐size‐fits‐all tactic. This review summarizes challenges and opportunities for clinical translation of advances in PET/CT‐guided radiotherapy, as well as in respiratory motion‐managed radiotherapy of lung cancer. These two concepts are then integrated into proposed patient‐specific workflows that span classification schemes, PET/CT image formation, treatment planning, and adaptive image‐guided radiotherapy delivery techniques.