Open Access Highly Accessed Review

Visualization, imaging and new preclinical diagnostics in radiation oncology

Clemens C Cyran1*, Philipp M Paprottka1, Michel Eisenblätter34, Dirk A Clevert1, Carsten Rist1, Konstantin Nikolaou1, Kirsten Lauber2, Frederik Wenz5, Daniel Hausmann6, Maximilian F Reiser1, Claus Belka2 and Maximilian Niyazi2

Author Affiliations

1 Department of Clinical Radiology, Laboratory of Experimental Radiology, University of Munich Hospitals, Campus Großhadern, Marchioninistraße 15, 81377 Munich, Germany

2 Department of Radiation Oncology, University of Munich Hospitals, Campus Großhadern, Marchioninistraße 15, 81377 Munich, Germany

3 IZKF Core Unit OPTI, Department of Radiology, University Hospital Muenster, Albert-Schweitzer-Campus 1, Muenster, Germany

4 Comprehensive Cancer Imaging Centre, Division of Imaging Sciences & Biomedical Engineering, King’s College London, The Rayne Institute, 4th Floor Lambeth Wing, St. Thomas Hospital, London SE1 7EH, UK

5 Department of Radiation Oncology, University Medical Centre Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, Mannheim 68167, Germany

6 Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

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Radiation Oncology 2014, 9:3  doi:10.1186/1748-717X-9-3

Published: 3 January 2014


Innovative strategies in cancer radiotherapy are stimulated by the growing knowledge on cellular and molecular tumor biology, tumor pathophysiology, and tumor microenvironment. In terms of tumor diagnostics and therapy monitoring, the reliable delineation of tumor boundaries and the assessment of tumor heterogeneity are increasingly complemented by the non-invasive characterization of functional and molecular processes, moving preclinical and clinical imaging from solely assessing tumor morphology towards the visualization of physiological and pathophysiological processes. Functional and molecular imaging techniques allow for the non-invasive characterization of tissues in vivo, using different modalities, including computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, positron emission tomography (PET) and optical imaging (OI). With novel therapeutic concepts combining optimized radiotherapy with molecularly targeted agents focusing on tumor cell proliferation, angiogenesis, and cell death, the non-invasive assessment of tumor microcirculation and tissue water diffusion, together with strategies for imaging the mechanisms of cellular injury and repair is of particular interest. Characterizing the tumor microenvironment prior to and in response to irradiation will help to optimize the outcome of radiotherapy. These novel concepts of personalized multi-modal cancer therapy require careful pre-treatment stratification as well as a timely and efficient therapy monitoring to maximize patient benefit on an individual basis. Functional and molecular imaging techniques are key in this regard to open novel opportunities for exploring and understanding the underlying mechanisms with the perspective to optimize therapeutic concepts and translate them into a personalized form of radiotherapy in the near future.

Radiation oncology; Molecular imaging; Functional imaging; Preclinical models