Image Guidance in Non–Small Cell Lung Cancer

New imaging technologies have advanced our ability to treat lung cancers through enhanced and extended visualization of the tumor as well as patient and treatment response. Image guidance can reduce uncertainty by increasing precision and accuracy through improved patient selection, target delineation, and improved knowledge of nodal involvement. Conformal imaging-based radiotherapy (RT) can allow dose escalation. In the future, imaging may allow adaptive RT to be exploited in selected patients, especially those with large geometric changes occurring during RT. Furthermore, functional imaging, although in its infancy, has the potential to significantly improve RT, from RT planning and delivery to outcome assessment.