Improving the application of PET to radiotherapy via preclinical research: Status and potential

Currently, radiotherapy is prescribed assuming homogeneous response to therapy across the patient population. Improving its efficacy is most likely to be achieved by personalisation to the individual patient. This can be achieved by improving target delineation for dose escalation, reducing toxicity, hypofractionation and dose painting approaches, as well as selecting patients via genomic or imaging biomarkers for the targeted use of radio-sensitising drugs, and the adaptation of radiotherapy in light of biological response. Molecular imaging with positron emission tomography (PET) has the potential to facilitate these approaches by providing a functional, 3D readout of tumour biology, however, this needs a sound evidence base for clinical trials in this area. Current preclinical models, equipment and protocol allow the variables that affect the application of PET to radiotherapy to be studied in detail and will be described here.

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