Session

Overview: This teaching lecture will focus on motion management strategies specifically when treating oligometastatic disease (OMD) in the thoracic and abdominal regions with SBRT. The lecture will be presented from the viewpoints of both the perspectives of the RTT and the medical physics expert (MPE). The MPE will start the lecture by giving a brief overview of the history of OMD. Concepts such as ITV, MidPos, MidVent and continuous target tracking will be discussed in the line of online adaptive delivery. The MPE will also pose a question over the optimal hardware for such treatment delivery- are ‘traditional’ linear accelerators sufficient or are dedicated, high technology units required? The RTT perspective will take the position of motion management when treating multiple volumes in the same plan on the MR-linac and will refer to the sites most commonly treated in this manner-lung, mediastinum, liver, abdominal volumes and abdominal lymph nodes. The presentation will follow the pathway from pre-treatment to on-treatment, leading to on-treatment decision making by the RTT with specific focus on what planes and which volumes to gate. Finally, some trouble shooting points will be given as well as consideration to questions which are still unanswered in this field.