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Open research questions in Advanced Radiotherapy Techniques

42 unresolved questions extracted from the limitations and future-work sections of 504 Advanced Radiotherapy Techniques papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • Further investigation is needed to explore optimal distribution of collimator rota- tions for a given treatment, the minimum number of collimator angles required to achieve sufficient IMRT treatment quality, comparison of static IMRT with multiple beam directions to volumetric mod- ulated arc therapy with the same leaf profiles, how the effectiveness of collimator rotations is affected by Biomed.

    Using collimator rotation to retain conformal dose distributions with thicker MLC leaves · 2026 · DOI

  • BackgroundIndependent end-to-end verification of adaptive radiotherapy on MR-Linac systems is limited by the lack of patient-specific phantoms able to reproduce imaging and dosimetric properties from CT and MRI scanners.

    Automated Design of Patient-Specific 4D-Printed Phantoms for Quality Assurance of Adaptive Radiotherapy on a 1.5T MR-Linac · 2026 · DOI

  • Propellant–material interaction & thermal exposure Experimental + ML-based regression to evaluate IS 2062 steel response under double-base propellant…

    Machine Learning-Driven Prediction of Radiation Shielding Performance of Aerospace Materials for Deep Space Missions · 2026 · DOI

  • However, a notable limitation arises when comparing these results to the ICRU-44 reference stan- dards, where larger discrepancies were observed. Based on the literature, no standardization in the developing process of 3DP anthropomorphic phantoms has been applied yet to this extent, which is essential for manu- facturing consistently high-quality phantoms that can further improve CT calibration procedures and new strategies as adaptive- and patient-specific radiotherapy.

    A standardized workflow for the development and manufacturing of tissue-equivalent anthropomorphic phantoms for radiotherapy using 3D-printing · 2026 · DOI

  • Randomized comparisons specific to robotic stereotactic delivery are lacking. Further prospective multicenter evaluation with standardized reporting and longer follow-up is warranted to define the relative role of CK-APBI among contemporary APBI options.

    Clinical Outcomes of Robotic Stereotactic Accelerated Partial Breast Irradiation: A Structured Literature Review · 2026 · DOI

  • Future research may focus on optimizing the gel composi- tion and MRI protocols to further refine dosimetric accuracy and broaden clinical applicability.

    Evaluation of an acrylic acid hydrogel dosimeter for 3-D dose verification in radiotherapy using MRI · 2026 · DOI

  • twice This study has several limitations. Firstly, dose measurements were performed for each imaging condition, which may underestimate random uncertainty; additional repetitions would be required for a more robust characterization of measurement variability and for supporting statistically significant analysis. Secondly, kVCT doses were measured using a fixed 10 cm scan length with a 100 mm pencil ionization chamber, which may underestimate the absolute dose due to incomplete scatter integration. Thirdly, the imaging protocols evaluated were limited to those used at three centers, which may not fully represent the range of clinical practices. Fourthly, dose measurements were based on a phantom-derived MSADw, which may not reflect patient-specific scan lengths and body sizes in clinical practice, affecting dose estimations. Finally, all measurements were performed at the isocenter, which may not accurately reflect patient positioning in clinical settings and could lead to variations in delivered dose.

    Assessment of imaging radiation dose from tomotherapy systems · 2026 · DOI

  • release of potentially hazardous This study used PLA as the primary material for 3D-printed bolus fabrication, which was selected based on a balance of radiological equivalence, mechanical performance, and manufacturing efficiency. While PLA offers advantages such as low ultrafine particle emissions compared with ABS and avoids the thermal decomposition byproducts, alternative materials may provide distinct benefits depending on clinical priorities.43 For example, silicone-based polymers processed via direct ink writing offer improved flexibility and tissue conformity, but their slow build speeds and limited spatial resolution constrain routine clinical use.16 Additionally, previous comparative studies have shown that although PLA demonstrates favorable radiation transmission characteristics, materials such as PETG may provide superior mechanical strength and flexibility.15 Accordingly, future work will systematically evaluate a broader range of printable materials to better balance radiological equivalence, mechanical performance, and manufacturing efficiency. Another limitation of this study is the use of only one FDM printer model and a specific PLA filament.

    Fabrication and evaluation of 3D-printed customizable boluses for optimized radiotherapy applications · 2026 · DOI

  • AI-enhanced ART has the potential to fully personalize radiotherapy, incorporating anatomical, functional, and biological parameters. Future directions include: • Biological adaptation with radiomics and functional imaging; • Digital twin models for individualized response and toxicity prediction; • Prospective clinical trials integrating AI into ART workflows.

    Artificial Intelligence–driven adaptive radiotherapy: Current developments, clinical applications and future perspectives · 2026 · DOI

  • Simulations assumed perpendicular beam incidence to the GSB lead, whereas clinical practice involves nonperpendicular beam incidence that could slightly alter the effective path length through the lead.

    Prediction of Therapeutic and Imaging Doses in the Gonadal Shielding Block Using Monte Carlo Simulation · 2026 · DOI

  • Beam irradiation was simulated from only four orthogonal angles, whereas actual rectal cancer irradiation typically uses a 360° arc or partial arc, excluding beams near 180°.

    Prediction of Therapeutic and Imaging Doses in the Gonadal Shielding Block Using Monte Carlo Simulation · 2026 · DOI

  • The simulation simplified the LINAC port geometry by including only the collimator, and scattered electron beams originating from the LINAC port were not considered, potentially leading to underestimation or incorrect modeling of scatter components critical for accurately predicting surface dose.

    Prediction of Therapeutic and Imaging Doses in the Gonadal Shielding Block Using Monte Carlo Simulation · 2026 · DOI

  • The research focused specifically on oropharyngeal cancer with a single arc and single STAMP configuration; applicability to other cancer sites and beam arrangement configurations remains unexplored.

    Can knowledge-based autoplanning keep up with advances in radiotherapy optimization for oropharyngeal cancer? · 2026 · DOI

  • However, basing on various concerns such as availability and security of using big data, and further work on polishing and testing AI algorithms, it is found that we may not ready to use AI primarily in radiotherapy at the moment.

    Artificial intelligence in radiotherapy · 2020 · DOI

  • The actual mean doses appropriate for liver irradiation in modern radiotherapy techniques have not been adequately investigated, although SBRT is sometimes alternatively performed using fractionated regimens.

    Validation of the liver mean dose in terms of the biological effective dose for the prevention of radiation-induced liver damage · 2017 · DOI

  • In addition, the complex role of the immune system, including the impact of immune competence on therapeutic response and the mechanisms through which these responses may be enhanced, is not yet fully understood.

    A Five-Year Institutional Experience With Spatially Fractionated Radiation Therapy for Palliative Management of Bulky Tumors Across Diverse Anatomical Sites · 2026 · DOI

  • Although further improvement in dose conformity is warranted, the proposed method is capable of generating treatment plans comparable to those created by experienced planners while substantially reducing planning time and inter-planner variability.

    Deep Reinforcement Learning-Based Automated Treatment Planning for a Rotating Gamma System · 2026 · DOI

  • Furthermore, the significant reduction in monitor units and the decrease in the low-dose bath (V2Gy and V5Gy) suggest a potential for minimizing the risk of secondary radiation-induced malignancies, although the specific impact of small partial arcs was not investigated.

    Objective-function-guided automated VMAT planning reduces OAR dose, low-dose exposure, and inter-planner variability in breast radiotherapy · 2026 · DOI

  • A water phantom was used instead of a human anthropomorphic phantom, which ignores changes in energy spectra occurring when beam passes through internal materials such as bone, potentially leading to underestimation or overestimation of internal scattering dose.

    Prediction of Therapeutic and Imaging Doses in the Gonadal Shielding Block Using Monte Carlo Simulation · 2026 · DOI

  • A water phantom was used assuming human body substance is equivalent to water, consequently not accounting for changes in energy spectrum such as beam hardening effects that occur when primary radiation passes through dense materials like spine and femur.

    Prediction of Therapeutic and Imaging Doses in the Gonadal Shielding Block Using Monte Carlo Simulation · 2026 · DOI

  • Electronic brachytherapy is a technique which may provide an alternative to high‐dose rate brachytherapy, but its use for the treatment of periocular tumours has not been reported, and the requirement for general anaesthesia is a significant disadvantage.

    Radiotherapy for the treatment of periocular tumours in the horse · 2017 · DOI

  • BACKGROUND: Radiotherapy of the prostate bed has a pivotal role in the post-operative and salvage settings, but few clinical data are available on the use of daily image guidance in combination with highly conformal techniques, and data on long-term results are lacking.

    Volumetric image-guided highly conformal radiotherapy of the prostate bed: Toxicity analysis · 2016 · DOI

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42 open questions have been extracted from the limitations and future-work passages of 504 Advanced Radiotherapy Techniques papers in our library. Each one below links back to the study that raised it, so you can read the original claim in context.

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