Table 1 Comparison of current clinical practice and research advances in motion-managed and PET/CT-guided radiotherapy of lung cancer
Process | Clinical practice | Research advance | Challenge | Opportunity |
|---|---|---|---|---|
PET/CT imaging | Static PET/CT for diagnosis and staging | Respiratory motion-tracked PET/CT for treatment planning simulation | Precision and accuracy in PET/CT quantification | Standardization of PET/CT protocols |
Treatment planning | Single plan from manual tumor segmentation with motion uncertainty margin | Adaptive plan from multi-phase tumor segmentation and biological target definition to maximize therapeutic ratio | Fast and reliable target definition from motion-managed PET/CT | Evaluation of potential therapeutic gains |
Treatment delivery | Image-guided radiotherapy | Image-guided and motion-tracked radiotherapy | Adaptive motion tracking algorithm | Real-time verification of dose under motion management |