The Image Biomarker Standardization Initiative validated consensus-based reference values for 169 radiomics features, thus enabling calibration and verification of radiomics software. Key results: • research teams found agreement for calculation of 169 radiomics features derived from a digital phantom and a human lung cancer on CT scan. • Of these 169 candidate radiomics features, good to excellent reproducibility was achieved for 167 radiomics features using MRI, 18F-FDG PET and CT images obtained in 51 patients with soft-tissue sarcoma.

Technological advances and clinical research over the past few decades have given radiation oncologists the capability to personalize treatments for accurate delivery of radiation dose based on clinical parameters and anatomical information. Eradication of gross and microscopic tumours with preservation of health-related quality of life can be achieved in many patients. Two major strategies, acting synergistically, will enable further widening of the therapeutic window of radiation oncology in the era of precision medicine: technology-driven improvement of treatment conformity, including advanced image guidance and particle therapy, and novel biological concepts for personalized treatment, including biomarker-guided prescription, combined treatment modalities and adaptation of treatment during its course.

For the first time, range verification based on prompt gamma imaging was applied for a clinical proton treatment. With the translation from basic physics experiments into clinical operation, the potential to improve the precision of particle therapy with this technique has increased considerably.