Online course

Clinical practice and implementation of image-guided stereotactic body radiotherapy

The course is aimed at all professionals in the field of radiation oncology who are involved in the clinical practice of SBRT and cranial SRS at any point in the treatment chain: radiation oncologists, physicists and radiation therapists (RTTs) with a dedicated focus on SBRT and SRS. The course targets individuals who are currently at the planning stage of establishing a clinical stereotactic programme, and also those who already have a current stereotactic practice. The importance of integrating all professionals into a team will be highlighted.

Course directors

  • Matthias Guckenberger, Radiation Oncologist, University Hospital Zurich, Zurich (CH)
  • Dirk Verellen, Medical Physicist, Iridium Kankernetwerk, University of Antwerp, Antwerp (BE)


  • Karin Dieckmann, Radiation Oncologist, Medical University of Vienna, Vienna (AT)
  • Mischa S. Hoogeman, Medical Physicist, Erasmus Medical Centre-Daniel den Hoed Cancer Centre, Rotterdam (NL)
  • Coen Hurkmans, Medical Physicist, Catharina Hospital, Eindhoven (NL)
  • Stephanie Lang, Medical Physicist, University Hospital Zurich, Zurich (CH)
  • Piet Dirix, Radiation oncologist, Iridium Network, GZA  Sint-Augustinus Department of Radiation Oncology, Antwerp (BE)
  • Suresh Senan, Radiation Oncologist, VU University Medical Centre, Amsterdam (NL)
  • Sophie Perryck, RTT, University Hospital Zurich, Zurich (CH)

This course aims to:


  • Inform about the historical background and development of cranial radiosurgery (SRS) and stereotactic- body radiotherapy (SBRT)
  • Illustrate the radiobiological consequences of hypo-fractionated, inhomogeneous dose distributions.
  • Discuss the practice of frame-less image-guided versus frame-based stereotactic cranial radiosurgery.
  • Identify potential sources of uncertainties in the work-flow of SBRT: imaging, target delineation, motion compensation, treatment planning, treatment delivery and treatment evaluation
  • Offer an overview of available treatment planning and delivery technologies and how to integrate these in clinical practice of SBRT •Compare available technologies and help define applicability for particular use
  • Give an evidence-based review on potential indications for SBRT: early stage NSCLC, primary and secondary liver metastases, prostate cancer, pancreatic cancer, vertebral metastases, oligometastases, re-irradiation
  • Give an overview of normal-tissue toxicity, tolerability and radiological changes in SBRT
  • Teach how to establish and implement a safe and clinical programme for SBRT.

Learning outcomes

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


  • Build a team to implement and practice SRS, SRT and SBRT
  • Understand the technical and physical requirements for SRS, SRT and SBRT
  • Know the clinical rationale of SRS, SRT and SBRT and their limitations
  • Understand the radiobiological basis of very high fraction doses
  • Know the details of indication, practice and outcome of SBRT for early stage NSCLC
  • Know the current clinical evidence for SRS, SRT and SBRT in the various clinical indications


Course content

The online course will consist of six modules:

  • Module 1: General aspects of SBRT
  • Module 2: SBRT for Stage I NSCLC
  • Module 3: SBRT for primary prostate cancer
  • Module 4: SBRT for pancreatic cancer
  • Module 5: SBRT for oligometastatic NSCLC
  • Module 6: SRS for brain metastases


Each module will put into focus a specific clinical case and will present challenges and solutions from a clinical, medical physics and also RTT perspective.


The covered topics will be:

  1. General aspects of SBRT
    1. What defines SBRT from a clinical and medical physics perspective?
    2. Dose and fractionation in SBRT and dose reporting based on ICRU 91
    3. Quality assurance and safety in SBRT
  2. SBRT for stage I NSCLC
    1. Current evidence and developments for SBRT in stage I NSCLC
    2. IGRT for targets with breathing motion
  3. SBRT for primary prostate cancer
    1. Current evidence for SBRT in primary treatment for prostate cancer
    2. IGRT for targets w/o breathing motion
  4. SBRT for pancreatic cancer
    1. Current evidence for SBRT in pancreatic cancer
    2. MRI-guided SBRT
  5. SBRT for oligometastatic NSCLC
    1. Current evidence for SBRT or local Tx in general in OMD
    2. SBRT treatment planning
  6. SRS for brain metastases
    1. Overview of SRS for treatment of brain metastases
    2. Split-up sessions by profession



Before commencing this course participant should:


  • Know the basics of image-guided radiotherapy
  • Have experience and knowledge of advanced radiotherapy treatment planning
  • Have a basic understanding of radiobiological modelling.


Teaching methods

  • 12 hours of lectures
  • 4 hours of practical case discussions


Methods of assessment

  • MCQ
  • Evaluation form


Course structure

Each module will consist of:

A 2-hour general lecture:

10 min

Presentation of a clinical case example

5 min


45 min

Clinical aspects of SBRT

5 min


45 min

Medical physics (and RTT) aspects of SBRT

10 min



During each lecture, participants will be able to discuss planning and contouring on specific clinical cases.


A 1-hour practical session, which will take place 1.5 weeks after:

15 min

Summary of the general lecture

15 min

Presentation of benchmark case: contours and plan

15 min

Presentation of variation between participants

15 min



NB Module 1 will not include a practical session.

The online programme is available here


The online course will include six modules, which delivered from 10 December 2020 until 9 February 2021 with twice-weekly sessions. Participants can choose to attend the entire course or single modules. It is only possible to register to single modules, not to single lectures or practical sessions.

Timeline per module

Chronological timeline