On the impact of functional imaging accuracy on selective boosting IMRT

Our study shows that the choice of a low-risk classification for the rPTV in selective boosting IMRT may lead to a significant loss in TCP. Furthermore, for the example considered in which normal tissue complications can be limited through the use of a tissue expander it appears that the therapeutic ratio can be improved using a functional imaging technique with a high sensitivity and limited specificity; while for cases were this is not possible, an optimal balance between sensitivity and specificity has to be found.