Novel MR-Guided Radiotherapy Elective Rotation for Radiation Oncology Trainees

Abstract

MR-guided adaptive radiation therapy (RT) is emerging as an integral treatment modality for certain applications and is poised to become an exciting opportunity for greater treatment precision and personalization. However, this is still a relatively nascent technology and only a few institutions and programs have access to this technology for clinical use and trainee education. To increase the diversity of elective offerings and improve the understanding of an MR-guided radiotherapy program, we initiated a unique MR-guided radiotherapy elective rotation for radiation oncology residents. During a representative four-week rotation, 21 simulations were completed by the resident on service. A plurality of simulations were for pancreas stereotactic body radiation therapy (SBRT; 48%) and a majority (71%) of simulations were for adaptive treatments. Additionally, 74 adaptive fractions were completed during this month, of which a significant majority (74%) were for pancreas SBRT. Of the non-adaptive fractions, the majority were for prostate SBRT and intensity-modulated radiation therapy (IMRT). Although many programs may offer training in some aspects of MR-guided radiotherapy as trainees rotate through certain disease sites, we hope this may serve as a blueprint to encourage programs with this technology to fully embrace training in essential competencies related to MR-guided radiotherapy. MR-guided radiotherapy has unique challenges that trainees need to understand to deliver treatment safely: geometric uncertainty, MRI to RT isocenter, and uncertainties with voxel size/tracking.

Assessment of Lymphoma and Other Hematologic Malignancies Training Needs Among Radiation Oncology Residents: a Brief Report

“…Specialized training within the mandatory RO curriculum exists [ 14 ]; however, “away” electives at outside institutions are uncommon due to administrative and logistical challenges. Our survey respondents noted similar concerns, with participation interest possibly limited by travel and housing costs.…”

Images and images: Current roles of therapeutic radiographers

“…15,24 This is not only important for MRIgRT but also the integration of MRI into C-arm linac radiotherapy, which is becoming more widely used. 17,50,51 It is essential that training programmes for new and/or complex techniques are robust as the additional training requires a collaborative effort between MDT members, the support of multiple centres, and radiotherapy education providers. 8,10,14,15,24,50 Especially given the small number of UK centres performing MRIgRT 52 and the complexity of the ART pathway.…”