Rome, Italy

MR-linac radiotherapy

BLENDED COURSE between 26 September and 29 October 2024  

ONLINE kick-off: Thursday 26 September 2024 from 11:00-12:00 CET

Between 26 September and 26 October students must view the online lectures available in ESTRO Moodle.

Live component with workshops in Rome, Italy, starting on Sunday 27 October 2024 until Tuesday 29 October 2024 at noon

This blended course is aimed at all professionals in the field of radiation therapy: radiation oncologists (ROs), medical physicists (MP) and radiation therapists (RTTs). In order to encourage teamwork, participation of multidisciplinary teams belonging to the same institute is encouraged, but not mandatory.

The course is intended for participants who are either directly involved in a clinical MR-guided RT project, or who want to update their knowledge on this topic.

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)


  • Stefanie Corradini, Radiation Oncologist, LMU Klinikum, Munich (DE)
  • 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 technological development in Image Guided Radiotherapy has led to the introduction of 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 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:

For all participants:

Multi-disciplinary introduction

• Introduction: From IGRT to in-room MRI-Guided Radiotherapy, the technology, medical and RTT

• MR-simulation and MR-guided Radiotherapy: common aspects and differences

• MRgRT and brachytherapy

In-room MRI

• Hybrid MR-guided RT machines: Low field vs. high field

• Clinical workflow of an in-room MRI-Guided Radiotherapy treatment

• In-room MR image processing and planning

Wrap up

• Online adaptive radiotherapy: workflow and criticalities

• RT and MR safety


For Radiation Oncologists and RTTs

MRI-guided adaptive radiotherapy

• MR Physics: Basic Introduction

• Artifacts in MRI: clinical point of view

• Decision Making: when do adapt a treatment fraction?

• Immobilization devices and MR simulation in MR-guided RT

• Management of breathing motion in MR-guided RT


For Radiation Oncologists

Clinical on-line MRI-guided radiotherapy

• Clinical Indications for MR-guided Radiotherapy treatment

• Patient selection criteria and compliance assessment

• Clinical Experience in MR-guided Radiotherapy

• Quantitative and functional imaging during MRI-guided Radiotherapy (RO/RTT)


For Physicists

MRI Physics

• Artifacts in MRI: physical point of view

• Quality Control for MR in Radiotherapy

• Motion management with MRI gating

Handling the magnetic field, motion and biology

• Dosimetry in the presence of magnetic fields

• Patient-specific QA in online adaptive MRgRT

• Quantitative and functional imaging during MRI-guided Radiotherapy (MP)


For RTTs:

On-line treatment towards functional guidance

• Patient Positioning: Brain, Head and Neck, Thorax, Upper Abdomen and Pelvis

• Practicalities for patient management and workflow

• Basic principles of OARs contouring on MR

• Quantitative and functional imaging during MRI-guided Radiotherapy (RO/RTT)

Course Design

This course will take place over a 4,5 weeks period and will be delivered using a blended learning approach, i.e. a combination of an online kick-off plus recorded online seminars and a live component with workshops in Rome.

An online kick-off webinar will be offered as the official introduction with the teachers and peers

  • The theoretical components will be delivered using the ESTRO Moodle, the ESTRO Virtual Learning Environment (VLE), where recorded presentations will be available for participants to join at a time that suits them before traveling to Rome (only available from 26 September onwards)
  • The live component in Rome will mainly consists out of brief summaries from the recorded lectures + workshops and ample time for discussion. 

For the updated calendar please consult the ESTRO website page of this course.


Defined for each of the disciplines, basic knowledge of radiation oncology, radiation physics and magnetic resonance imaging are prerequisites.

Teaching Methods

  • 1 hour live webinar
  • 20 hours of viewing recorded tutorials
  • 15 hours of live course in Rome

Methods of Assessment

• MCQ (pre & post course)

• Evaluation form

Thursday 26 September 2024 – 11:00-12:30 CET - course introduction and 3 live remote lectures.  From this date onwards the recorded lectures will be made available to all students

These must be viewed before attending the live part of the course in Rome
Sunday 27 to Tuesday 29 October 2024 – live course in Rome: brief summaries from the recorded lectures + workshops and ample time for discussion.  We will also visit the hybrid linear accelerator at the Agostino Gemelli hospital.


Please consult this webpage on a regular basis for further programme updates.




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).
  • the European Board for Accreditation in Medical Physics (EBAMP) as CPD event for Medical Physicists at EQF Level 7

Information on the status of the applications can be obtained from the ESTRO office.

NH Villa Carpegna

Via Pio IV, 6

00165 Roma, Italy



ESTRO members can order products at substantially reduced prices. To benefit from the member registration rate, you must subscribe for the ESTRO membership 2024 BEFORE registering to the course. To become an ESTRO member, benefit from the member registration rate and discover the many other member advantages, please visit the membership page.



Early rate

Late rate


  750 EUR

 850 EUR

ESTRO Members

  575 EUR 

 725 EUR

In-training members*

  425 EUR

 575 EUR

* Members with specialty RadiationTherapist (RTT) may register at the In-Training fee

Early rates are applied up to three months before the starting date of the course.

Late rates are applied three months before the starting date of the course.

The fee includes the course material, coffees, lunches, and the social event.

Advance registration & payment are required.

Access to homework and/or course material will become available upon receipt of full payment.

Insurance and cancellation

ESTRO does not accept liability for individual medical, travel or personal accidents or incidents. Participants are strongly advised to take out their own personal insurance policies.   

For any cancellation made by the course or workshop participant, ESTRO School Events Cancellation Policy will be followed and all stated penalty fees will be applied. 

In the unlikely event that ESTRO would need to cancel the event, ESTRO will reimburse the participants in full for the registration fee. ESTRO will not refund any travel and accommodation expenses.

Reduced fees

Members from emerging countries may register at a preferential rate of 350 Euro. Emerging country fee applies to individuals from low-income and lower-middle-income economies according to the World Bank listing here.

Additionally, for this teaching course, all specialties from the following countries can benefit from this preferential rate: Albania, Belarus, Bosnia and Herzegovina, Bulgaria, Hungary, Macedonia, Moldova, Montenegro, Romania, Russian Federation, Serbia, Turkey, Ukraine.  In addition, medical physicists from Cyprus can email to apply for this fee.

The preferential rate of 350 Euro is granted automatically when you click on the  BOOK NOW  button and the

conditions below are met:

  1. Only ESTRO members for 2024 are eligible (please make sure your 2024 membership is in order before you click on the BOOK NOW button)
  2. The application is submitted 3 months before the course start date.
  3. Only one course per person per year can be subsidized by ESTRO
  4. Sponsored candidates are not entitled to reduced fees (the invoicing address has to be the one of the participant)  
  5. The are limited spaces available for each course in the price category. Places are granted on “first come first serve” basis.