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)

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 opens 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 systems 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 and live teleconferencing:

• 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, but best before each Q&A session.
• 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.  Summaries from the recorded lectures will be presented followed by ample Q&A time, also clinical cases treated by in-room MRI-guided RT radiotherapy will be discussed.

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

• 16 hours of pre-recorded lectures
• 10 hours of live teleconference tutorials

FULL ONLINE course between 7 October and 9 November 2021

As from 7 October pre-recorded lectures will be available for participants to study at their own pace prior to the online Q&A sessions. The pre-recorded lectures will be available from ESTRO Moodle.

Zoom sessions on:

Thursday 7 Oct from 14:00-15:30 CET – kick-off

Wednesday 13 Oct from 09:00-10:00 CET – Q&A session

Tuesday 19 October from 14:00-15:00 CET – Q&A session and case discussions

Tuesday 26 October from 14:00-15:00 CET – Q&A session for Radiation Oncologists – however other disciplines also welcome to join

Wednesday 27 October from 14:00-15:00 CET – Q&A session for RTTs – however other disciplines also welcome to join

Thursday 28 October from 14:00-15:00 CET – Q&A session for Medical Physicists – however other disciplines also welcome to join

Wednesday 3 November from 17:00-18:00 CET – final Q&A session

Tuesday 9 November from 14:00-17:00 CET – Recap session, discuss MCQs and closing session

The programme schedule corresponds to CET (Brussels) timing

Methods of Assessment

• MCQ

• Evaluation form

Programme

The draft scientific programme is available here

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.

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

*  All specialties: Albania, Belarus, Bosnia and Herzegovina, Bulgaria, Croatia, Czech Republic, Estonia,, Greece, Hungary, Latvia, Lithuania, Macedonia, Moldova, Montenegro, Poland, Portugal, Romania, Russian Federation, Serbia, Slovak Republic, Slovenia, Spain, Turkey, Ukraine

RTTs and physicists only: Cyprus  

RTTs only: Italy 

To apply for the above rate, please contact education@estro.org at least 2 weeks before the start of the course. Thereafter, the desk rate will be applied.

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

The standard rate is applied up to 2 weeks before the starting date of the course.

Desk rates are applied 2 weeks before the starting date of the course.

Advance registration & payment are required.              

Registration will close on the date published on the front page of the course.
 

Cancellation

A registration to the online workshop may be cancelled without any fees before pre-online course material is sent out. Pre-online course material is sent out a few days before the first workshop lesson. After the pre-online course material is sent out, no refund of the  registration fee is possible.

Fee for ESTRO members working in countries with a less competitive economic background:

ESTRO members working in countries with a less competitive economic background can benefit from the above fees 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. Sponsored candidates are not entitled to these fees (the invoicing address has to be the one of the participant)  
3. Your application is submitted 2 weeks before the course start date