Molecular image-guided radiotherapy
(2024) Basic Clinical Radiobiology — ISBN: [9781003278337], p. 250-269, published
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- Abstract
- Molecular imaging, also referred to as biological imaging or functional imaging, is the use of non-invasive imaging techniques that enable the visualization of various biological pathways and physiological characteristics of tumors and/or normal tissues. In short, it mainly refers (but not only) to positron emission tomography (PET) and magnetic resonance imaging (MRI). In clinical oncology, molecular imaging offers the unique opportunity 1) to allow an earlier diagnosis and staging of the disease, 2) to contribute to the selection and delineation of the optimal target volumes before and during (i.e. adaptive treatment) radiotherapy and to a lesser extent before surgery, 3) to monitor the response early on during the treatment or after its completion, and finally 4) to help in the early detection of tumor recurrence. From the viewpoint of experimental radiation oncology, molecular imaging may bridge radiobiological concepts such as tumor hypoxia, tumor proliferation, tumor stem cell density and tumor radiosensitivity by integrating tumor biological heterogeneity into the treatment planning equation (Figure 22.1). From the viewpoint of experimental oncology, molecular imaging may also facilitate and speed up the process of drug development by allowing faster and cheaper pharmacokinetic and biodistribution studies. Figure 22.1 Molecular imaging bridges radiobiological concepts such as tumor hypoxia, tumor proliferation and tumor radiosensitivity into the treatment planning equation. A conceptual framework highlights the integration of tumour biological heterogeneity into treatment planning through molecular imaging. It connects hypoxia, repopulation, and intrinsic radiosensitivity with the molecular pathways. It indicates that imaging techniques, such as P E T and M R I, can assess these factors for an optimized approach. The pathways include key signalling cascades like the P I 3 K and A K T, M A P K, and D N A damage response pathways, which regulate cell survival, proliferation, apoptosis, and repair mechanisms.
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Grégoire, V., Beuf, O., Draulans, C., Haustermans, K., & Lee, J. (2024). Molecular image-guided radiotherapy. In Joiner, Michael ; Kogel, Albert van der (Eds.) (ed.), Basic Clinical Radiobiology (p. p. 250-269). CRC Press. https://doi.org/10.1201/9781003278337-22