Now is the Time for Personalized Imaging Protocols in Cancer Diagnosis and Radiotherapy

Since the discovery of X-ray in 1895, medical imaging procedures, particularly those involving ionizing radiation such as computed tomography (CT) and cone-beam computed tomography (CBCT), have been playing a crucial role in cancer diagnosis and radiotherapy, revolutionizing our ways to detect and fight cancers at every stage of disease [1,2]. Driven largely by advances in technological development as well as a fee-for-service healthcare model, the use of medical imaging modalities in cancer diagnosis and radiotherapy has increased dramatically in the past thirty years [3,4]. For example, it is estimated that more than 81.2 million CT procedures were performed in the United States alone in 2014, which are 7% higher than the procedures performed in 2013 and 27 times increase as compared to 3 million CT scans in 1980 [5]. The same trend of increasing usage of CT, CBCT and other medical imaging procedures, particularly in pediatric diagnosis, adult screening and tumor localization during radiation therapy, has been observed at other countries as well, and the trend is expected to continue for the next few years [6].