Session

Overview: Radiation induced normal tissue toxicity from proton therapy observed mainly in Brain and Head and Neck cancer patients is a serious problem that requires a multidisciplinary effort to better understand the underlying radiobiologic cause. In this session the speakers with various foci will give us insights into different imaging modalities ( quantitative MRI and PET) for lesion evaluation, differentiation between pseudo progression, tumor progression and radiation necrosis. Furthermore, modeling voxelwise risk of lesion occurrence using statistical/AI methods and how this can be transferred to predict a patient level risk of radiation necrosis will be presented and how these models may influence treatment planning strategies. Finally, preclinical imaging of normal tissue toxicity allowing for avoidance of unclear contributions from tumor response allows for greater insight of the underlying radiation sensitivity effect in the rodent brain. Together, these presentations illuminate our evolving understanding of the serious radiobiological effect seen in high dose regions following proton therapy.