Artificial intelligence in radiation therapy: from imaging to delivery—a comprehensive review

Abstract Artificial intelligence (AI) is revolutionizing radiotherapy by enhancing precision, efficiency, and personalization in patient care. AI offers innovative solutions to longstanding challenges in radiation oncology by streamlining workflows, improving treatment accuracy, and alleviating the burden of heavy workloads on healthcare professionals, which is particularly critical in addressing current staffing shortages. As AI continues to evolve, its applications in radiotherapy are expected to expand, underscoring the need for healthcare providers to understand its current uses and future potential. This review provides a comprehensive analysis of AI’s role across all stages of the radiotherapy workflow, from imaging and treatment planning to quality assurance and delivery. By focusing on recent advancements and key areas of implementation, the review highlights how AI is transforming clinical workflows and improving patient outcomes. Additionally, this review addresses the critical topic of AI regulations and guidelines, which are essential for its safe and ethical integration into clinical practice. It also explores AI’s applications in clinical trials, emphasizing its role in enhancing trial efficiency and reliability. By examining these aspects, this review offers a detailed overview of the current state of AI in radiotherapy and its potential to shape the future of cancer treatment.