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 Directors

  • Andrew Hope, Radiation Oncologist, Princess Margaret Hospital, Toronto (CA)
  • Jan-Jakob Sonke, Medical Physicist, Netherlands Cancer Institute, Amsterdam (NL)


  • Rianne de Jong, Radiation Therapist, Academic Medical Centre, Amsterdam (NL)
  • Uwe Oelfke, Medical Physicist, The Royal Marsden NHS Foundation Trust, London (UK)
  • Parag Parikh, Radiation Oncologist, Henry Ford Cancer Institute, Detroit (USA)
  • Marcel van Herk, Medical Physicist, The Christie, University of Manchester, Manchester (UK)

Course Aim

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.‚Äč

Methods of Assessment

  • MCQ
  • Evaluation form.



Draft programme 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. To benefit from the member registration rate, you must subscribe for the ESTRO membership 2023 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


 500 EUR

 600 EUR

ESTRO Members

 400 EUR 

 600 EUR

In-training members*

 350 EUR

 600 EUR

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

The early online rate is applied until two months before the start of the course.

Late online rates are applied as of two months before the start of the course

Advance registration & payment are required.              

Registration will close on the date published on the front page of the course.


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 an unlikely event that ESTRO would need to cancel the event, ESTRO will reimburse the participants in full for the registration fee.

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, all specialties from the following countries can benefit from this preferential rate: 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.  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 three conditions below are met:

  1. Only ESTRO members for 2023 are eligible (please make sure your 2023 membership is in order before you click on the BOOK NOW button)
  2. Only one course per person per year can be subsidized by ESTRO
  3. Sponsored candidates are not entitled to reduced fees (the invoicing address has to be the one of the participant)  

 Please note:

  • We can only guarantee a certain number of reduced fees per course
  • Application deadlines
    • 2 months before the start of the course for online attendance