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Tomography
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Progress in the Use of Advanced Imaging for Radiation Oncology
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Progress in the Use of Advanced Imaging for Radiation Oncology

A special issue of Tomography (ISSN 2379-139X). This special issue belongs to the section "Cancer Imaging".

Deadline for manuscript submissions: 30 April 2026 | Viewed by 5187

Special Issue Editors

Prof. Dr. Hui-Kuo Shu

E-Mail Website
Guest Editor
Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30322, USA
Interests: CNS tumors; pediatric malignancies; radiation oncology; proton therapy; radiosurgery; MRI; MR spectroscopy; radiomics; advanced imaging; quantitative imaging
Dr. Bree Eaton

E-Mail Website
Guest Editor
Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30322, USA
Interests: radiation oncology; proton therapy; pediatric malignancies; pediatric brain tumors

Special Issue Information

Dear Colleagues,

The field of radiation oncology seeks to improve outcomes of cancer patients by treating their malignancies with ionizing radiation. Imaging is integral to the practice of radiation oncology not only to aid in treatment planning but also for serial response assessment. As technological advances have continued to improve the ability to deliver radiation doses more accurately, this has further increased the need to develop more advanced imaging modalities to better determine the extent of disease involvement as well as the precise localization of surrounding critical normal tissues.

This Special Issue seeks to highlight the increasing use of advanced imaging in radiation oncology and how this may improve the outcomes of patients with cancer. We encourage researchers to submit original research articles, comprehensive reviews, case reports or other report types that do not necessarily fit the previous categories that focus on use of advance imaging modalities that can impact the practice of radiation oncology.

Prof. Dr. Hui-Kuo Shu
Dr. Bree Eaton
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Tomography is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • CT
  • MRI
  • PET
  • radiation oncology
  • advanced imaging
  • quantitative imaging
  • cancer

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (4 papers)

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Research

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15 pages, 1334 KiB  
Article
Optimizing Radiation Risk Assessment in CT Imaging: Establishing Institutional Diagnostic Reference Levels and Personalized Dose Strategies for Chest, Abdomen, and Pelvis Scans
by Zuhal Y. Hamd, Huda I. Almohammed, Elbagir Mansour, Abdoelrahman Hassan A. B. and Awadia Gareeballah
Tomography 2025, 11(6), 65; https://doi.org/10.3390/tomography11060065 - 3 Jun 2025
Viewed by 173
Abstract
Background: As a diagnostic radiology procedure, computed tomography (CT) contributes to patient radiation exposure; hence, it deserves special consideration. The use of diagnostic reference levels (DRLs) is an efficient way to optimize patient radiation dosage. The computed tomography dose index volume (CTDIv) and [...] Read more.
Background: As a diagnostic radiology procedure, computed tomography (CT) contributes to patient radiation exposure; hence, it deserves special consideration. The use of diagnostic reference levels (DRLs) is an efficient way to optimize patient radiation dosage. The computed tomography dose index volume (CTDIv) and the dose-length product (DLP) help to measure DRLs. Methods: A retrospective analysis was conducted on 106 patients (43.9% male, 56.1% female; mean age of 48.18 years) who underwent computed tomography chest, abdomen, and pelvis (CT CAP) scans using a Toshiba Aquilion Prime 160-slice CT scanner. Data included patient demographics, CT parameters (mA, tube rotation time, pitch, slice thickness, and slice count), and dose indices: dose length product (DLP), computed tomography dose index volume (CTDIvol), and effective dose. Cancer risks were calculated based on effective dose, patient demographics, and scan parameters. Results: This study demonstrated that the mean values for DLP, CTDIvol, and effective dose were 1719.64 ± 488.45 mGy·cm, 25.97 ± 6.96 mGy, and 27.5 ± 7.82 mSv, respectively. Cancer risk estimates ranged from 0.048% to 1.58%, with higher risks observed for females, younger patients. Significant correlations were found between dose indices and technical parameters, including pitch, kVp, tube rotation time, and slice thickness (p < 0.005). Conclusions: The mean values for DLP, CTDIvol, and effective dose for abdominopelvic scans were higher than those found in previous studies, with significant correlation of weight on these values. Optimizing CT protocols and establishing DRLs tailored to clinical indications are critical for minimizing radiation exposure and enhancing patient safety. Full article
(This article belongs to the Special Issue Progress in the Use of Advanced Imaging for Radiation Oncology)
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16 pages, 5375 KiB  
Article
The Utility of Spectroscopic MRI in Stereotactic Biopsy and Radiotherapy Guidance in Newly Diagnosed Glioblastoma
by Abinand C. Rejimon, Karthik K. Ramesh, Anuradha G. Trivedi, Vicki Huang, Eduard Schreibmann, Brent D. Weinberg, Lawrence R. Kleinberg, Hui-Kuo G. Shu, Hyunsuk Shim and Jeffrey J. Olson
Tomography 2024, 10(3), 428-443; https://doi.org/10.3390/tomography10030033 - 20 Mar 2024
Cited by 3 | Viewed by 2583
Abstract
Current diagnostic and therapeutic approaches for gliomas have limitations hindering survival outcomes. We propose spectroscopic magnetic resonance imaging as an adjunct to standard MRI to bridge these gaps. Spectroscopic MRI is a volumetric MRI technique capable of identifying tumor infiltration based on its [...] Read more.
Current diagnostic and therapeutic approaches for gliomas have limitations hindering survival outcomes. We propose spectroscopic magnetic resonance imaging as an adjunct to standard MRI to bridge these gaps. Spectroscopic MRI is a volumetric MRI technique capable of identifying tumor infiltration based on its elevated choline (Cho) and decreased N-acetylaspartate (NAA). We present the clinical translatability of spectroscopic imaging with a Cho/NAA ≥ 5x threshold for delineating a biopsy target in a patient diagnosed with non-enhancing glioma. Then, we describe the relationship between the undertreated tumor detected with metabolite imaging and overall survival (OS) from a pilot study of newly diagnosed GBM patients treated with belinostat and chemoradiation. Each cohort (control and belinostat) were split into subgroups using the median difference between pre-radiotherapy Cho/NAA ≥ 2x and the treated T1-weighted contrast-enhanced (T1w-CE) volume. We used the Kaplan–Meier estimator to calculate median OS for each subgroup. The median OS was 14.4 months when the difference between Cho/NAA ≥ 2x and T1w-CE volumes was higher than the median compared with 34.3 months when this difference was lower than the median. The T1w-CE volumes were similar in both subgroups. We find that patients who had lower volumes of undertreated tumors detected via spectroscopy had better survival outcomes. Full article
(This article belongs to the Special Issue Progress in the Use of Advanced Imaging for Radiation Oncology)
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Review

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26 pages, 4766 KiB  
Review
Applications of Advanced Imaging for Radiotherapy Planning and Response Assessment in the Central Nervous System
by Liam S. P. Lawrence, Rachel W. Chan, Amit Singnurkar, Jay Detsky, Chris Heyn, Pejman J. Maralani, Hany Soliman, Greg J. Stanisz, Arjun Sahgal and Angus Z. Lau
Tomography 2025, 11(6), 68; https://doi.org/10.3390/tomography11060068 (registering DOI) - 12 Jun 2025
Abstract
Background/Objectives: Radiotherapy for tumors of the central nervous system (CNS) could be improved by incorporating advanced imaging techniques into treatment planning and response assessment. The objective of this narrative review is to highlight the recent developments in magnetic resonance imaging (MRI) and positron [...] Read more.
Background/Objectives: Radiotherapy for tumors of the central nervous system (CNS) could be improved by incorporating advanced imaging techniques into treatment planning and response assessment. The objective of this narrative review is to highlight the recent developments in magnetic resonance imaging (MRI) and positron emission tomography (PET) for applications in CNS radiotherapy. Methods: Recent articles were selected for discussion, covering the following topics: advanced imaging on MRI-linear accelerators for early response assessment in glioma; PET for guiding treatment planning and response assessment in glioma; and contrast-enhanced imaging and metabolic imaging for differentiating tumor progression and radiation necrosis for brain metastasis treatment. Where necessary, searches of scholarly databases (e.g., Google Scholar, PubMed) were used to find papers for each topic. The topics were chosen based on the perception of promise in advancing specific applications of CNS radiotherapy and not covered in detail elsewhere. This review is not intended to be comprehensive. Results: Advanced MRI sequences and PET could have a substantial impact on CNS radiotherapy. For gliomas, the tumor response to therapy could be assessed much earlier than using the conventional technique of measuring changes in tumor size. Using advanced imaging on combined imaging/therapy devices like MR-Linacs would enable response monitoring throughout radiotherapy. For brain metastases, radiation necrosis and tumor progression might be reliably differentiated with imaging techniques sensitive to perfusion or metabolism. However, the lack of level 1 evidence supporting specific uses for each imaging technique is an impediment to widespread use. Conclusions: Advanced MRI and PET have great promise to change the standard of care for CNS radiotherapy, but clinical trials validating specific applications are needed. Full article
(This article belongs to the Special Issue Progress in the Use of Advanced Imaging for Radiation Oncology)
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Other

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16 pages, 1419 KiB  
Conference Report
Conference Report: Review of Clinical Implementation of Advanced Quantitative Imaging Techniques for Personalized Radiotherapy
by Yevgeniy Vinogradskiy, Houda Bahig, Nicholas W. Bucknell, Jeffrey Buchsbaum and Hui-Kuo George Shu
Tomography 2024, 10(11), 1798-1813; https://doi.org/10.3390/tomography10110132 - 14 Nov 2024
Viewed by 1230
Abstract
The topic of quantitative imaging in radiation therapy was presented as a “Masterclass” at the 2023 annual meeting of the American Society of Radiation Oncology (ASTRO). Dual-energy computed tomography (CT) and single-positron computed tomography were reviewed in detail as the first portion of [...] Read more.
The topic of quantitative imaging in radiation therapy was presented as a “Masterclass” at the 2023 annual meeting of the American Society of Radiation Oncology (ASTRO). Dual-energy computed tomography (CT) and single-positron computed tomography were reviewed in detail as the first portion of the meeting session, with data showing utility in many aspects of radiation oncology including treatment planning and dose response. Positron emission tomography/CT scans evaluating the functional volume of lung tissue so as to provide optimal avoidance of healthy lungs were presented second. Advanced brain imaging was then discussed in the context of different forms of magnetic resonance scanning methods as the third area noted with significant discussion of ongoing research programs. Quantitative image analysis was presented to provide clinical utility for the analysis of patients with head and neck cancer. Finally, quality assurance was reviewed for different forms of quantitative imaging given the critical nature of imaging when numerical valuation, not just relative contrast, plays a crucial role in clinical process and decision-making. Conclusions and thoughts are shared in the conclusion, noting strong data supporting the use of quantitative imaging in radiation therapy going forward and that more studies are needed to move the field forward. Full article
(This article belongs to the Special Issue Progress in the Use of Advanced Imaging for Radiation Oncology)
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