Radiation and Cancer Physics

Panel 03 - Functional Imaging for Biologically-Guided Adaptive Radiotherapy

4:45 PM - 6:00 PM
Location: Room W181

Session Type: Panel
1.25 AMA PRA Category 1 Credits™
1.25 CAMPEP Credits
1.5 MDCB Credits

Functional imaging of tumor and normal tissue biology provides novel opportunities to optimize radiotherapy by identifying refined critical structures and biological target volumes (BTVs) within the tumor for preferential targeting. Advances in imaging and adaptive radiotherapy techniques can result in improved dose response relationships for normal tissues and patient-specific radiotherapy. Speakers will discuss recent and noteworthy advances in the combined use of functional imaging and adaptive radiotherapy to exploit heterogeneity in tumor and normal tissue biology. These include the development of a novel method for obtaining functional information about normal lung tissue using dual-energy CT. Patient-specific information about lung function is incorporated into treatment optimization. Results will be presented for a phase II trial aimed at prospectively determining the prognostic value of tumor hypoxia in H&N patients and targeting tumor volumes defined by [18F]fluoromisonidazole-PET/CT with dose escalation. Despite a history of mixed clinical results, this study provides compelling evidence that hypoxia is associated with poor outcomes and dose escalation to hypoxic volumes is feasible without excess toxicity. Finally, results of a trial combining functional lung avoidance and adaptive dose escalation in NSCLC patients will be presented. Treatment optimization includes dose reduction to [99mTc]MAA-SPECT/CT perfused lung and escalation of dose to BTVs. Advanced imaging and adaptive planning have the potential to increase the therapeutic ratio of conventional radiotherapy by increasing tumor control while reducing normal tissue toxicity. Functional imaging is now safely being used to optimize radiotherapy, but the impact on patient outcomes must be evaluated through randomized prospective clinical trials.

Learning Objectives:


David Carlson, PhD

University of Pennsylvania

Yale University School of Medicine: Associate Professor: Employee;
Yale-New Haven Hospital: Medical Physicist II: Employee

David J. Carlson, PhD, DABR, FAAPM is an Associate Professor at the Yale University School of Medicine and a Medical Physicist at Yale-New Haven Hospital. He completed his residency in Radiation Oncology Physics at Stanford University and received his PhD from Purdue University. He is a Senior Associate Editor for the International Journal of Radiation Oncology, Biology, and Physics, a member of several ASTRO committees, and a past member of the Board of Directors of the AAPM.


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Panel 03 - Functional Imaging for Biologically-Guided Adaptive Radiotherapy

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