Course Directors

• Uulke van der Heide, Medical Physicist, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands (NL)
• Luca Boldrini, Radiation Oncologist Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome (IT)

Teachers

• Vincenzo Valentini, Radiation Oncologist, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome (IT)
• Cihan Gani, Radiation Oncologist, University Hospital Tuebingen, Tuebingen (DE)
• Sebastian Klűter, Medical Physicist, University Hospital Heidelberg, Heidelberg (DE)
• Faisal Mahmood, Medical Physicist, Odense University Hospital ,Odense (DK)
• Helen McNair, Lead Research Radiographer, The Royal Marsden NHS Foundation Trust, Sutton (UK)
• Stella Mook, Radiation Oncologist, UMC Utrecht, Utrecht (NL)

Local Organiser

Ben Slotman, Radiation Oncologist, Amsterdam UMC, Amsterdam (NL)

The recent technological development in Image Guided Radiotherapy has led to the introduction of new hybrid machines linking an MRI scanner to a linear accelerator. The possibility to have high soft tissue contrast with no extra dose to the patient and live imaging to gate the treatment delivery open new frontiers in the world of adaptive radiotherapy. The complexity of this new discipline requires advanced skills in the fields of physics and radiotherapy.

In this interdisciplinary course, we aim to:

- Provide a detailed overview of the clinical rationale and indications of in-room MRI-guided RT;

- Deepen the knowledge of the clinical, physical and technical aspects of MRI-guided RT

implementation in clinical practice;

- Share opportunities and challenges of the MRI-guided radiotherapy sytems in different clinical scenarios.

Learning Outcomes

By the end of this course participants should be able to:

• Understand the technology underlying the hybrid MR Linac system, discussing the differences between high and low magnetic field machines
• Appreciate the clinical rationale of in room MRI-guided RT and its possible applications in the frame of modern IGRT
• Understand the clinical workflow of an in-room MRI-guided RT treatment and the role of all the involved professionals
• Become familiar with the most innovative online adaptive radiotherapy approaches
• Identify the most appropriate patients positioning solutions
• Appreciate the different planning strategies of MRI-guided RT
• Become familiar with patients selection criteria and MRI safety issues.

Course Content/Programme

The course will cover the following topics:

• Introduction: From IGRT to in-room MRI-Guided Radiotherapy, the technology, medical and RTT perspective
• MR-simulation and MR-guided Radiotherapy: common aspects and differences 
• Clinical workflow of an in-room MRI-Guided Radiotherapy treatment
• Basic knowledge on in-room MR image processing and planning
• Low-Field versus High Field MRI hybrid machines
• Quality controls for commissioning and routine treatment
• Patient quality assurance in MR-guided RT and dose accumulation
• Quality Control for MR in Radiotherapy
• MR-gating systems: criticalities and control quality
• MR Physics: Basic Introduction
• Artifacts in MRI: clinical point of view
• Clinical Experience in MR-guided Radiotherapy
• Clinical Indications for MR-guided Radiotherapy treatment
• Breathing techniques in MR-guided RT
• Patient Positioning: Brain, Head and Neck, Thorax, Upper Abdomen and Pelvis
• Dosimetry in presence of magnetic fields
• Principles of deformable image registration
• Quantitative and functional imaging during MRI-guided Radiotherapy
• Artifacts in MRI: physical point of view
• Immobilization devices and MR simulation in MR-guided RT
• Decision Making: when do adapt a treatment fraction?
• Patient selection criteria and compliance assessment
• Quantitative and functional imaging during MRI-guided Radiotherapy
• Practicalities for patient management
• Basic principles of OARs contouring on MR
• Online adaptive radiotherapy: workflow and criticalities
• RT and MR safety
• Dose Accumulation

Course Design

The course will take place over a 5 weeks period and will be delivered using a blended learning approach, i.e. a combination of recorded online seminars, live teleconferencing and face-to-face teaching:

• The theoretical components will be delivered using the ESTRO Moodle, the ESTRO Virtual Learning Environment (VLE), where recorded seminars will be available for participants to join at a time that suits them.
• Additionally, live teleconference tutorials will also take place to provide participants with the opportunity to discuss their learning to date with the teachers and peers.

The face-to-face component of the course will occur over a three-day period in Amsterdam and mainly consists out of summaries from the recorded lectures with Q&A, workshops where clinical cases treated by in-room MRI-guided RT radiotherapy will be discussed, group discussions of the assignments per discipline and multidisciplinary.

For the updated calendars please consult the ESTRO website page of this course.

Prerequisites

Defined for each of the disciplines, basic knowledge of radiation oncology, radiation physics and magnetic resonance imaging are prerequisites.

Teaching Methods

• 5 hours of online lectures
• 4 hours of live teleconference tutorials
• 1 practical course of 3 days with workshops

Methods of Assessment

• MCQ

• Evaluation form

Programme

The scientific programme will be available soon.

Further Reading

To be provided if available.

Accreditation

Application for CME recognition will be submitted to the European Accreditation Council for Continuing Medical Education (EACCME), an institution of the European Union of Medical Specialists (UEMS) . EACCME  credits are recognised by the American Medical Association towards the Physician’s Recognition Award (PRA). Information on the status of the applications can be obtained from the ESTRO office.

Venue

To follow

Membership

ESTRO members can order products at substantially reduced prices. Please note that in order to benefit from the member price, you must renew your membership for 2021 before registering to the course.To benefit from these member rates, please visit the membership page to become a member or renew your membership BEFORE proceeding with your order.

Fees

* Members with specialty RadiationTherapist (RTT) may register at the In Training fee

Early rates are applied up to three months before the starting date of the course.

Late rates are applied three months before the starting date of the course.

The fee includes the course material, coffees, lunches, and the social event.

Advance registration & payment are required.

Since the number of participants is limited, late registrants are advised to contact the ESTRO office before payment, to inquire about availability of places. Access to homework and/or course material will become available upon receipt of full payment.

Insurance and cancellation

The organiser does not accept liability for individual medical, travel or personal insurance. Participants are strongly advised to take out their own personal insurance policies.   

In case an unforeseen event would force ESTRO to cancel the meeting, the Society will reimburse the participants fully the registration fees. ESTRO will not be responsible for the refund of travel and accommodation costs.

In case of cancellation, full refund of the registration fee minus 15% for administrative costs may be obtained up to three months before the course and 50% of the fee up to one month before the course. No refund will be made if the cancellation request is postmarked less than one month before the start of the course.

Reduced fees

ESTRO members from economically challenged countries may register at a preferential rate of 350 Euro if three conditions are met:

1. Only ESTRO members for 2021 are eligible (please make sure your 2021 membership is in order before you apply for the reduced fees)
2. Only one course per person per year can be subsidized by ESTRO
3. Sponsored candidates are not entitled to reduced fees (the invoicing address has to be the one of the participant)  

Please note: