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Review
. 2022 Oct 27;14(21):5277.
doi: 10.3390/cancers14215277.

Integration between Novel Imaging Technologies and Modern Radiotherapy Techniques: How the Eye Drove the Chisel

Giulio Francolini  1 , Ilaria Morelli  2 , Maria Grazia Carnevale  2 , Roberta Grassi  3   4 , Valerio Nardone  3   4 , Mauro Loi  1 , Marianna Valzano  2 , Viola Salvestrini  2 , Lorenzo Livi  2 , Isacco Desideri  1   2
Affiliations
Review

Integration between Novel Imaging Technologies and Modern Radiotherapy Techniques: How the Eye Drove the Chisel

Giulio Francolini et al. Cancers (Basel). .

Abstract

Introduction: Targeted dose-escalation and reduction of dose to adjacent organs at risk have been the main goal of radiotherapy in the last decade. Prostate cancer benefited the most from this process. In recent years, the development of Intensity Modulated Radiation Therapy (IMRT) and Stereotactic Body Radiotherapy (SBRT) radically changed clinical practice, also thanks to the availability of modern imaging techniques. The aim of this paper is to explore the relationship between diagnostic imaging and prostate cancer radiotherapy techniques.

Materials and methods: Aiming to provide an overview of the integration between modern imaging and radiotherapy techniques, we performed a non-systematic search of papers exploring the predictive value of imaging before treatment, the role of radiomics in predicting treatment outcomes, implementation of novel imaging in RT planning and influence of imaging integration on use of RT in current clinical practice. Three independent authors (GF, IM and ID) performed an independent review focusing on these issues. Key references were derived from a PubMed query. Hand searching and clinicaltrials.gov were also used, and grey literature was searched for further papers of interest. The final choice of papers included was discussed between all co-authors.

Results: This paper contains a narrative report and a critical discussion of the role of new modern techniques in predicting outcomes before treatment, in radiotherapy planning and in the integration with systemic therapy in the management of prostate cancer. Also, the role of radiomics in a tailored treatment approach is explored.

Conclusions: Integration between diagnostic imaging and radiotherapy is of great importance for the modern treatment of prostate cancer. Future clinical trials should be aimed at exploring the real clinical benefit of complex workflows in clinical practice.

Keywords: multi-parametric magnetic resonance imaging; prostate cancer; prostate imaging-reporting and data systems; prostate-specific membrane antigen PET/CT; radiomics.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart showing the relationship between new diagnostic imaging technologies and modern treatment planning in the management of prostate cancer. ABBREVIATIONS: mpMRI, multi-parametric Magnetic Resonance Imaging; PI-RADS, Prostate Imaging–Reporting and Data System; IGRT, Image-Guided Radiation Therapy; MRI-LINAC, Magnetic Resonance Imaging Guided Linear Accelerator; AE, Adverse Events.
See this image and copyright information in PMC

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