Target-volume selection and delineation in the cervico-maxillo-facial region: beyond the concepts of the ICRU

摘要

Improvement in irradiation techniques, which allows dose distributions sculpting around volumes of very complex shapes, has revealed the limitations in selection and delineation of target volumes. The use of functional imaging (PET, fMRI) in addition to anatomic imaging, will probably bring an extra level of complexity to this issue. In particular, the use of specific markers to visualize biological pathways known to influence response to ionizing radiation (e.g. hypoxia, proliferation) could lead to the delineation of sub-target volumes for delivering an extra boost dose. Such concept of Image-Guided Radiation Therapy still need to be tested in experimental models and in well defined clinical situations before its use in a routine clinical set-up.