Imaging of normal lung, liver and parotid gland function for radiotherapy

Acta Oncol. 2010 Oct;49(7):997-1011. doi: 10.3109/0284186X.2010.504735.


There is growing clinical evidence that functional imaging is useful for target volume definition and early assessment of tumour response to external beam radiotherapy. A subject that has perhaps received less attention, but is no less promising, is the application of functional imaging to the prediction or measurement of radiation adverse effects in normal tissues. In this manuscript, we review the current published literature describing the use of positron emission tomography (PET), four-dimensional computed tomography (4D-CT), single photon emission computed tomography (SPECT) and magnetic resonance imaging (MRI) to study normal tissue function in the context of radiotherapy to the lung, liver and head & neck. Published results to date demonstrate that functional imaging can be used to preferentially avoid normal tissues not easily identifiable on solely anatomical images. It is also a potentially very powerful tool for the early detection of radiotherapy-induced normal tissue adverse effects and could provide valuable data for building predictive models of outcome. However, one of the major challenges to building useful predictive models is that, to date, there are very little data available with combined images of normal function, 3D delivered radiation dose and clinical outcomes. Prospective data collection through well-constructed studies which use established morbidity scores is clearly a priority if significant progress is to be made in this area.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Computer Simulation
  • Diagnostic Imaging / methods*
  • Humans
  • Liver / anatomy & histology
  • Liver / diagnostic imaging
  • Liver / physiology*
  • Lung / anatomy & histology
  • Lung / diagnostic imaging
  • Lung / physiology*
  • Models, Biological
  • Parotid Gland / anatomy & histology
  • Parotid Gland / diagnostic imaging
  • Parotid Gland / physiology*
  • Radiation Injuries / physiopathology
  • Radiation Injuries / prevention & control
  • Radiography
  • Radionuclide Imaging
  • Radiotherapy / adverse effects
  • Radiotherapy / methods*
  • Radiotherapy Planning, Computer-Assisted / methods