Adaptive Approaches and Online Monitoring of Radiotherapy Treatment

25 April 2018

Manchester Conference Centre

Organised by IPEM's Radiotherapy Special Interest Group

Only a mere 20 years ago, you could be forgiven for thinking radiotherapy patients did not move and their tumours did not change during treatment! We know this because radiotherapy treatments were set up to external fiducial markers and treatment delivered with no, or little, image verification. Treatment borders were large and required no further validation. However whilst treatments were effective, side effects were prevalent.

Wind the clock forward to 2018. The demands on the radiotherapy delivery system have increased significantly with the introduction of new techniques and technologies. Tumours are no longer considered square and static, margins are tighter and there is a real need for validation and verification of treatment in real time, on an individual patient basis.  Online monitoring is therefore becoming a desirable feature to be fully incorporated in modern radiotherapy, as a means to avoid errors, verify treatment delivery and highlight changes in machine performance. It also plays a major role in adaptive treatment where imaging can inform not only positioning but also the need for re-planning.

Many contemporary technologies may be employed to monitor radiotherapy treatment in real, or near-real time to provide assurance. These include systems such as:

  • In-vivo diodes,
  • EPID (Electronic Portal Imaging Device) imaging and dosimetry,
  • glass beads thermo-luminescent dosimeters,
  • non-orthogonal Image based monitoring,
  • ultrasound imaging, optical surface tracking,
  • MRI (Magnetic Resonance Imaging) on the Linac,
  • Electromagnetic transponders,
  • treatment machine log file analysis and reconstruction, and
  • optical and physical delivery gating systems.

Despite recommendations made in 2010 (Towards Safer Radiotherapy) and 2012 (NRIG IGRT Guidance for Implementation and Use),  to use real time monitoring systems to reduce and correct uncertainty resulting from patient physiological movements, online monitoring technology for Radiotherapy Treatment is yet to mature and be fully integrated in clinical pathways in radiotherapy departments.

Target audience
Radiotherapy Professionals (Scientific/Technical, Radiography, Oncologists)

Educational Aims
1. To provide a stimulating forum for the exchange of ideas regarding online monitoring and how it is developing, as well as how it fits in within the wider spectrum of QA methods.
2. To provide an opportunity for users to learn how to overcome any issues they are encountering so they can fast track implementation. 
3. Provide information to delegates about the different commercial and in-house systems that have been developed to support online radiotherapy treatment monitoring and to expand ideas on the intended use of commercial monitoring systems to new novel applications within radiotherapy

Anticipated Learning Outcomes
1. Learning outcomes will include an understanding of the status of online monitoring systems currently available, together with those under development.

2. Delegates are expected to be able to describe different equipment and modes of use for various commercial and in-house online monitoring systems and be able to identify the benefit that these systems bring to patient treatment.

3. Delegates will be able to identify gaps in their own local radiotherapy services and utilise information provided during the meeting to plan future developments and implementations to support improved patient treatment.  Attendees will also learn about implementation issues for commercially available systems within the UK and learn who are the key players in this field, for networking opportunities.

Invited Speakers
The emerging MR-Linac platform may provide the ultimate panacea, though still to be clinically implemented in the UK, Prof Michael Roach from Washington University School of Medicine, St Louis, USA will give a keynote address highlighting the practical implementation and patient benefits that can be realised.
Geoff Budgell of the Christie NHS Foundation Trust in Manchester will give an invited talk on Adaptive on-line planning and patient position monitoring with the Elekta Unity MR Linac.
Conference Resources
- Download the latest programme here
- Download abstracts here
- Download Invited Speaker biographies here  
- Presentation slides will be available after the event here (IPEM Members only - login required)
Registration is now closed. For any queries, email the IPEM Conference Team or ring 01904 550598.  

Registration fees:
IPEM member: £165
IPEM member trainee: £140
IPEM member technologist: £125
IPEM member student/retired/non-salaried: £95
Non-member: £215

Please note there is a £20 discount on these prices if booked up to 6 weeks in advance.
Full prices apply from 14th March 2018

Registration deadline: 11th April 2018

This conference will take place at the Manchester Conference Centre in central Manchester: 

Manchester Conference Centre
Sackville Street
M1 3BB

This is within approx 5-10 mins walk of both Manchester Piccadilly station and Manchester Oxford Road station. For a map, directions and parking information, 
visit the Manchester Conference Centre website

Accommodation is available within the conference centre at the Pendulum Hotel. For details 
visit their website

Note from hotel:
Preferential rate when you book direct – 25% off our accommodation rate of the day!!  Access code: DELMCC
Simply enter the access code on our website or telephone our reservations team on 0161 955 8000 to secure your rate.

If you have any queries, please 
email the IPEM conference team or tel: 01904 550598. 

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