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Image-guided radiotherapy for esophageal cancer

Maria A Hawkins and Katharine Aitken

Esophageal cancer continues to be a diagnostic and therapeutic challenge in the multidisciplinary oncology setting. External beam radiotherapy has an established role in the radical management (i.e., preoperative or definitive) of esophageal malignancies. Successful delivery of accurate radiotherapy techniques requires a detailed understanding of esophageal anatomy, multimodality imaging (e.g., CT and endoscopic ultrasound and PET) to visualize the tumor and involved lymph nodes, an individualized assessment of organ motion, and precise patient immobilization prior to treatment. The practicing clinician is advised to utilize the current technological advances in imaging, prior to and during radiotherapy, to ensure precise radiotherapy delivery. This article will provide a summary of current imaging techniques incorporated in modern radiotherapy planning.