Ascending role of functional visualization modalities for navigation of external bean radiation therapy and brachytherapy in case of prostate cancer

There are many options for combining brachytherapy with external beam radiation therapy, as well as with systemic anticancer therapy in the first line, as well as in the treatment of localized tumor recurrence in a previously irradiated area. A distinctive feature of brachytherapy is a sharp drop in the dose outside the tumor focus, which minimizes the risk of irradiation of surrounding organs and tissues. The main advantage of brachytherapy over external beam radiation therapy is the higher radiation dose gradient at the tumor border. Functional imaging techniques hold enormous potential for personalized optimization of radiotherapy, and especially brachytherapy, for all stages of prostate cancer. The introduction of innovative technologies and interdisciplinary integration allows in each individual case to precisely increase the effectiveness and reduce the toxicity of focal therapy. Based on the evidence-based experience accumulating in the world, it is necessary to improve the indications, namely, to whom and when to assign this or that method of functional imaging.