In the future, ultrasound guidance in radiotherapy will become a clinical standard.

Abstract

In modern radiotherapy, imaging is an important component in the treatment process where it is used for planning the doses to be delivered and for verifying and monitoring the position of the target during treatments. Recent developments in imaging have contributed to advancing radiotherapy techniques’ such as image-guided radiotherapy (IGRT) for intrafraction motion management and adaptive radiation therapy (ART). This is has resulted in the ability to deliver highly conformal radiation doses with increased precision, which has enabled the safe increase in the dose that can be delivered to the tumour, resulting in improvements in clinical outcomes and the implementation of hypofractionated radiotherapy regimens. Although x-ray imaging has predominantly been used in radiotherapy for many years, more complex radiotherapy such as ART, demands an imaging modality with greater soft tissue contrast so radiotherapy targets can be imaged directly. A requirement that has led to the recent introduction of the MR-linac. Ultrasound also offers soft tissue contrast and may have advantages in terms of imaging rates, we therefore considered it pertinent to consider the role of ultrasound imaging in future radiotherapy treatments. In this timely debate, Emma Harris and Davide Fontanarosa discuss whether ultrasound guidance in radiotherapy will become a clinical standard in the future.