Modern Imaging in Brachytherapy

The imaging revolution with Ultrasound, Computed Tomography, and Magnetic Resonance Imaging entered the world of treatment planning in external beam radiation therapy in the 80ies and 90ies, step by step (9). With the support of modern computer technology, this has led to sophisticated, widespread, 3D sectional image based treatment planning, that nowadays increasingly forms an essential integral part of daily practice treatment planning in a radiation oncology department with regard to external beam therapy. Included in this process are 3D assessment of anatomy, PTV and critical organs, 3D dose calculations with dose volume histograms, and different forms of 3D display capabilities (for example beam ́s eye view, digitally reconstructed radiographs). The next step is being made by more systematically including biological models based on data derived from clinical experience. Tools are at present being developed for predicting tumour control probability (TCP) and normal tissue complication probabilities (NTCP), for example in lung and prostate cancer treatment.