Online course

Image guided radiotherapy and chemotherapy in gynaecological cancer: focus on MRI based adaptive brachytherapy for Cervical Cancer

The course is aimed at radiation oncologists, medical physicists and radiation therapists (RTTs) involved in the treatment of gynaecological cancer. Course participants should have specific interest in the implementation of state of the art image guidance techniques for external beam radiotherapy (EBRT) and brachytherapy.

Course Directors

  • Remi Nout, Radiation Oncologist, Erasmus Medical Center, Rotterdam (NL) 
  • Kari Tanderup, Medical Physicist, University Hospital, Aarhus (DK)


  • Simon Duke, Radiation Oncologist/PhD Student, Addenbrooke´s Hospital- Oncology Centre, Cambridge (UK)
  • Ina Jürgenliemk-Schulz, Radiation Oncologist, University Medical Centre, Utrecht (NL) 
  • Umesh Mahantshetty, Radiation Oncologist, Tata Memorial Hospital, Mumbai (IN)      
  • Nicole Nesvacil, Medical Physicist, Medical University Hospital, Vienna (AT) 
  • Primoz Petric, Radiation Oncologist, Aarhus University Hospital (DK)      
  • Richard Pötter, Radiation Oncologist, Medical University Hospital, Vienna (AT)              
  • Monica Serban, Medical Physicist, McGill University Health Centre, Montreal (CA)
  • Li Tee Tan, Radiation Oncologist, Addenbrooke’s Hospital - Oncology Centre, Cambridge (UK)


The course aims to: 

  • Teach about principles of 3D image-based EBRT and brachytherapy including techniques and treatment planning in gynaecological cancer
  • Provide understanding of commissioning, quality assurance, principles of planning, plan evaluation and reporting of 2D and 3D brachytherapy with focus on cervical cancer
  • Introduce 3D image-based (adaptive) target concepts of GTV, CTV and PTV including both EBRT and brachytherapy with focus on cervical cancer
  • Enable practical implementation of 3D techniques in EBRT and brachytherapy with focus on cervical cancer
  • Provide an overview on radiation therapy (external radiation and brachytherapy) and clinical outcome in gynaecological cancers.
  • Enhance the practical implemention and logistics for transition to 3D/4D in the existing environment.
  • Provide further roadmap and steps of intervention to improve the existing standards

Learning Outcomes

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

  • Understand the rationale of image guidance and apply concepts of advanced brachytherapy techniques in clinical practice
  • Perform contouring and treatment planning for 3D image guided EBRT and brachytherapy in clinical practice
  • Implement procedures for 3D image guided brachytherapy focussed on cervical cancer in own department
  • Implement advanced EBRT techniques in cervical cancer in own department.
  • Give feedback and review of hurdles in implementation.

Course Content

  • Normal, pathologic anatomy and clinical examination of female pelvis 
  • Image based anatomy including US, CT, MRI and conventional radiography
  • CTV/ITV/PTV for external irradiation
  • Combination of external irradiation and brachytherapy
  • Different application techniques in brachytherapy
  • Commissioning and Quality Assurance of various processes involved in 3D treatment planning.
  • Application techniques in brachytherapy including combined intracavitary-interstitial applicators
  • Treatment planning for brachytherapy
  • ICRU 89 concepts: GTV, CTV, PTV at diagnosis and at time of brachytherapy for 2D and 3D brachytherapy (adaptive target concept)
  • Dose, dose-rate and fractionation and overall treatment time
  • Radiobiological effects from combined external irradiation and brachytherapy, linear quadratic model
  • Prescribing, recording and reporting including ICRU 89 - GEC-ESTRO recommendations and ESGO/ESTRO/ESP guidelines for the management of patients with cervical cancer
  • Therapeutic outcome: radio-chemotherapy, image based EBRT and brachytherapy including EMBRACE.


Course participants should have specific interest in and/or initial experience with implementation of advanced MRI based brachytherapy and advanced EBRT techniques (IMRT/IGRT).

Teaching Methods

The course has a blended learning approach where recorded lectures (homework), practical exercises (homework) and web-based interactive sessions and feedback are combined.

The course includes:

Kick-off – live web (2h):

              Introductory live web-meeting with all participants and faculty

Optional lectures - homework (~ 8h)

Viewing of recorded lectures on background knowledge (basic principles of anatomy, clinical evidence, physics, background of other gynaecological cancers etc). Depending on experience this module can have duration up to around 8h.

Mandatory lectures - homework (~ 8h)

              Viewing of recorded lectures on key learning objectives

Practical exercises - homework (~ 8h)

             Medical Doctors: contouring of provided EBRT and BT cases
             Medical Physicists and RTTs: EBRT and BT treatment planning on provided cases

Interactive sessions – live web (~10h)

In 5 blocks of 2 hours the participants will meet with the faculty in interactive live web sessions. The five blocks will address: 1) EBRT contouring, 2) EBRT planning, 3a) Clinical aspects of brachytherapy (for MDs), 3b) Physics aspects of brachytherapy (for medical physicists and RTTs), 4) Brachytherapy contouring and 5) Brachytherapy treatment planning. The interactive sessions will include: summary of mandatory homework lectures, quizzes, feedback on homework (contouring and treatment planning) and Q&A.

Extra material:

              Videos of clinical workflow (3h): OR procedures and treatment planning

Methods of Assessment

  • Contouring and dose planning exercises
  • Interactive feedback between participants and faculty through web-based moderated modules
  • Feedback on homework
  • MCQ (interactive sessions during the web modules)
  • ESTRO teaching course evaluation form.



Final programme available here

Key Words

  • Evidence based multi-modality management guidelines<
  • 2D to 3D transition
  • 3D Image Guided Adaptive Brachytherapy (IGABT) in cervical cancer
  • Contouring guidelines for advanced EBRT including IMRT/ IGRT and image-based brachytherapy with focus on cervical cancer

Further Reading

Will be specified under Learning Objectives (available for participants after registration on ESTRO Moodle)


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.




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.



Standard Rate

Desk Rate

ESTRO members working in countries with a less competitive economic background*/ In-training members**

 350 EUR

 600 EUR


 400 EUR 

 600 EUR

Non Members

 500 EUR

 600 EUR

*  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 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.


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