Track 44: Multidisciplinary Tumor Boards and Imaging-Based Clinical Decision Making

Multidisciplinary tumor boards (MDTBs) are an integral component of modern oncology practice, designed to ensure comprehensive, coordinated, and patient-centered cancer care. These structured meetings bring together specialists from diverse disciplines—including radiologists, pathologists, medical oncologists, surgical oncologists, radiation oncologists, nuclear medicine physicians, palliative care experts, and oncology nurses—to review individual patient cases and collaboratively formulate optimal treatment strategies.

Imaging is a central pillar in MDTB decision-making. Radiological assessments from CT, MRI, PET-CT, ultrasound, and specialized imaging protocols provide critical insights into tumor morphology, anatomical relationships, vascular involvement, locoregional spread, and distant metastasis. Radiologists play a key interpretive role, clarifying disease staging, identifying resectability, and highlighting subtle findings that may influence treatment planning. Advanced imaging technologies such as functional MRI, PET radiotracers beyond FDG, diffusion- and perfusion-based mapping, as well as emerging radiomics and artificial intelligence tools, further enhance predictive accuracy and treatment planning.

Pathology complements imaging by confirming tumor subtype, grade, molecular profile, and biomarker expression, which guide decisions regarding targeted therapy, chemotherapy, immunotherapy, or hormone-based interventions. The integration of imaging and pathology fosters precision medicine, ensuring treatment approaches are aligned with both tumor biology and disease extent.

During the course of therapy, imaging supports ongoing monitoring and modification of clinical management. Standardized response criteria, such as RECIST or PERCIST for metabolic response assessment, help assess therapeutic efficacy, detect recurrence, and guide second-line or salvage strategies. Imaging also plays an essential role in identifying treatment complications that may require timely intervention.

MDTBs also promote transparent communication, reduce treatment delays, ensure consistency in clinical practice, and support shared decision-making with patients and their families. This collaborative structure minimizes fragmented care and enhances clinical outcomes by aligning interventions with current best evidence and individual patient needs.

Overall, multidisciplinary tumor boards that integrate imaging-based decision-making represent a cornerstone of high-quality oncology practice, driving precision, efficiency, and improved patient survival and quality of life.