Radiology and Radiation Therapy: Partners in Patient Care

The time has come for a closer partnership between the fields of radiology and radiation therapy, David Jaffray, PhD, said to a roomful of attendees at this year’s recent RSNA 2013 meeting in Chicago.

As head of radiation physics at the Ontario Cancer Institute and Princess Margaret Hospital, Jaffray said strengthening this relationship can lead to a new level of precision in diagnostics and therapy.

“We have the capacity to shape dose in way to target abnormalities while avoiding critical normal structures,” he said. “And, what we’re doing today with the integration of imaging and radiation therapy - it goes beyond genomics. It’s true personalization in response to intervention.”

By including imaging with radiation therapies, providers can get immediate feedback on treatments and can change their actions based on the patient’s response. This merger can also decrease dose exposure, especially, he said, in cases where providers are targeting malignant tumors but don’t want to harm any healthy tissue.

“Does it make sense to irradiate the same problems if tumors are shrinking?” he said. “Are we introducing toxicity to regions what we know has no disease?”

For example, at the Ontario Cancer Institute, radiation therapists in the brachytherapy suite are using MRI studies to determine whether their therapy efforts should be adapted. These images can help radiation therapists track tumor metabolism, collagen density, tumor proliferation, and any new targets that may develop, he said.

Most importantly, he said, effective use of imaging during radiation therapy can identify when a certain line of treatment is no longer working, giving providers the opportunity to select and alternate strategy and, potentially, improve patient outcomes.

“Giving personalize care requires that we have imaging data of tissue characteristics at their best,” Jaffray said. “We have to know how an intervention performs, and only by integrating all of these things can we really understand cancer and the developing cancer medicines and strategies. Imaging is a powerful tool that can make that happen.”