The Future of Medical Dosimetry

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More than 40 years ago, I began my career in radiation therapy. Since then, I’ve witnessed—and been a part of—one of the most fascinating evolutions in healthcare. Here are 10 predictions based on what I’ve seen, where we are now, and where I believe we’re heading.

1. AI Will Assist, Not Replace, Dosimetrists

While some may fear that AI will fully replace human planners, current limitations suggest otherwise. AI can quickly generate contours and suggest planning parameters, but dosimetrists remain essential in evaluating and fine-tuning treatment plans for each patient’s unique needs.

2. Dosimetrists Will Shift into an Evaluator Role in AI-Driven Treatment Planning

The implementation of AI will likely shift the dosimetrist’s role toward evaluating AI-generated contours and plans. This shift will allow dosimetrists to guide, correct, and finalize planning outcomes with a focus on precision and patient safety.

3. Adaptive Planning Will Become a Standard in Medical Dosimetry

Adaptive planning, supported online or remotely by dosimetrists, will become a major part of the field. As daily variations in patient anatomy are considered, dosimetrists will oversee adjustments that ensure continued treatment accuracy.

4. Biologic Modeling Will Transform Treatment Planning

Currently possible but crude, biologic modeling will become more refined. Dosimetrists will soon be able to accurately account for dose effects across differing fractionation schedules and sum plans with improved biological accuracy.

5. Image Registration and Deformation Will Evolve

As image registration advances, future tools will enable not only the deformation of anatomy but also the deformation and summation of dose. These improvements will enhance precision in tracking cumulative doses across multiple treatments.

6. Renewed Focus on Brachytherapy and Radiopharmaceutical Dosimetry

Although currently less emphasized due to the demands of IMRT, brachytherapy, and radiopharmaceutical dosimetry will likely see renewed interest and development, offering expanded treatment pathways.

7. Education and Training Will Gain Even Greater Importance

With increasing complexity in technology and planning, the need for advanced education and continuous training will be critical. Dosimetrists will need to stay ahead of the curve through continuing education and skill development.

8. Research Involvement Will Expand

As planning techniques and technology evolve, dosimetrists will become more engaged in research and protocol development, helping shape the direction of the profession.

9. Dose Escalation Will Help Reduce Treatment Cost

As dose escalation allows for fewer fractions without compromising tumor control, this method will gain traction. It promises not only clinical benefits but also potential reductions in overall treatment costs.

10. Dosimetrists Will Help Train AI for Better Accuracy

AI will continue to evolve through feedback. Dosimetrists will increasingly participate in training AI systems, helping them better understand planning goals and refining their output for future clinical use.

As someone who has spent over four decades in the field, I can confidently say the future of medical dosimetry is full of promise. The role of the dosimetrist will not diminish but rather transform and grow with technology. I look forward to seeing how we continue to adapt, lead, and innovate in the years ahead.