Image-Guided and Adaptive Radiotherapy

Learn the principles of image guided and adaptive radiotherapy; understand how to implement and evaluate them in your own institution, depending on workflow and resources

The course is aimed at all professionals in the field of radiation oncology who are involved in target localisation at any point in the treatment chain. This includes radiation oncologists, medical physicists,and radiation therapists (RTTs). A good understanding of issues related to target delineation, target localisation and patient set-up is a prerequisite as well as some experience in the field. As the emphasis will be on the integration of image guidance and adaptive techniques as well as their practical implementation, the “team effort” is important. Simultaneous participation of physicists, radiation oncologists and radiation therapists is strongly encouraged.

Course Director

  • Coen Rasch, Radiation Oncologist, Leiden University Medical Centre (NL)


  • Rianne de Jong, Radiation Therapist, Academic Medical Centre, Amsterdam (NL)
  • Andrew Hope, Radiation Oncologist, Princess Margaret Hospital, Toronto (CA)
  • Uwe Oelfke, Medical Physicist, The Royal Marsden NHS Foundation Trust, London (UK)
  • Parag Parikh, Radiation Oncologist, Henry Ford Cancer Institute, Detroit (USA)
  • Jan-Jakob Sonke, Medical Physicist, Netherlands Cancer Institute, Amsterdam (NL)
  • Marcel van Herk, Medical Physicist, The Christie, University of Manchester, Manchester (UK)

Local Organiser

  • TBC

The course aims to:

  • Cover both theoretical and practical aspects related to the clinical implementation of in-room imaging and plan adaptation in radiotherapy
  • Review imaging techniques that can be applied in the workflow of conformal radiotherapy and understand how individual links in the chain of events will influence clinical outcome (from treatment prescription to preparation and planning, to patient set-up and verification)
  • Identify potential sources of errors in target delineation / localisation and how IGRT can be of help, with special emphasis on conformal radiotherapy, intensity modulated radiotherapy, adaptive radiotherapy and management of organ motion
  • Discuss the concept “target delineation
    • target localisation” at each particular step in the treatment chain and identify appropriate techniques to increase both efficiency as well as efficacy
  • Discuss the concept of treatment adaptation and its implementation in the context of the present technological capabilities
  • Offer an overview of available technologies and how to integrate these in clinical practice
  • Compare available strategies and help define applicability for particular use
  • Present the functionality of the equipment and technology, and identify limitations of a particular method
  • Present practical recommendations for establishing an efficient image-guided workflow through optimal integration of available technologies and to emphasise the importance of teamwork and training
  • Present the components of a QA strategy of IGRT systems.

Learning Outcomes

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

  • Understand the principles of image guided and adaptive radiotherapy Implement image guidance for major patient groups in their home clinic
  • Understand the relevant choices for the selection of the best image guidance protocol for their home situation
  • How to start adaptive radiotherapy in their clinic
  • Know the benefits of various image guidance and ART protocols.

Course Content

This is a 5-day course organised to identify the influence of image guidance at important steps in the workflow of radiation therapy. The following items will be covered in view of in-room imaging for therapy guidance:

  • Image guidance required for treatment prescription
  • Image guidance in treatment preparation and treatment planning
  • Image guidance in patient set-up and target localisation during treatment
  • Strategies and software tools for adaptive radiotherapy
  • Image guidance in treatment follow-up
  • MR-guided radiotherapy.

Teaching Methods

  • Lectures and workshops
  • Regular breakout sessions for MDs, physicists and radiation therapists. Time will be allocated as follows:
    • 23 hours of lectures
    • 3 hours of tutorials
    • 4 hours of case discussions / exercise.

Methods of Assessment

  • MCQ
  • Evaluation form.




Available here

Key Words

Image guidance, adaptive radiotherapy.

Further Reading

Please consult the ESTRO website page of this course for further information.


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

Early deadline: 22 September 2021