STATE OF THE ART RADIOTHERAPY EDUCATION DAYVenue: Stewart House, London

CPD: 5 CREDITS

10DECEMBER

2014

More information available soon at www.bir.org.uk

• Room1Primers for the non-specialistsSessionorganisedbyDrDavid

Wilson,ConsultantInterventional

MSKradiologist,OxfordUniversity

HospitalsNHSTrust

• Room2Radiation protectionSessionorganisedbyMrAndy

Rogers,HeadofRadiationPhysics,

NottinghamUniversityHospitals

NHSTrust

Save the date

• Room1Clinical hybrid imaging in oncologySessionorganisedbyDrGopinath

Gnanasegaran,Consultant

PhysicianinNuclearMedicine,

StThomas’Hospital

• Room2Musculoskeletal imagingSessionorganisedbyDrRichard

Wakefield,Consultantin

Rheumatology,StJames’s

UniversityHospital

Essentials for the radiology traineeSessionorganisedbyDrHardi

Madani,RadiologyRegistrar,

RoyalFreeLondonHospital,and

DrAusamiAbbas,Cardiothoracic

RadiologyPostCCTFellow,

UniversityHospitalAlberta

Day 2Day 1

BIR ANNUAL CONGRESS 20154–5 NOVEMBER

LONDON

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Save the date

Day 2

Welcomeandthankyouforcomingtoour‘Stateoftheartradiotherapyeducationday’organisedbytheBritishInstituteofRadiology.

Wewishyouaveryenjoyableandeducationalexperience.

Certificateofattendance

Thismeetinghasbeenawarded5RCRcategoryICPDcredits.

Yourcertificateofattendancewillbeemailedtoyouwithinthenexttwoweeksonceyouhavecompletedtheonlineeventsurveyat:

https://www.surveymonkey.com/s/Radiotherapyeducationday

BIR Annual Congress 2015: 4–5 November, London

We are most grateful to

for supporting this conference.

Please take the time to visit their exhibition stands to find out more about the services they offer.

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Programme

09:15 Registration and refreshments

09:40 Welcome and introduction MrsNicolaBlackler LeadDosimetristPlanningandTrials,DerrifordHospital

09:45 Setting up the treatment unit: intelligence-guided QC MrGeoffBudgell TeamLeaderforVerificationandDosimetry, TheChristieNHSFoundationTrust

10:15 Imaging in radiotherapy: current options available DrTimWood ClinicalScientist,HullandEastYorkshireHospitalsNHSTrust

10:45 Refreshments

11:15 Chemotherapy: principles and new developments DrMartinHighley ConsultantOncologist,PlymouthOncologyCentre,DerrifordHospital

11:40 Target volume definition MrJamieFairfoul HeadofRadiotherapyPlanning, PeterboroughandStamfordHospitalsNHSFoundationTrust

12:05 SABR gating and 4DCT MrAndrewPoynter ConsultantClinicalScientistandHeadofRadiotherapyPhysics, PeterboroughandStamfordHospitalsNHSFoundationTrust

12:30 Lunch

13:30 Basic and advanced treatment planning MsHayleyJames HeadofRadiotherapyPhysics,IpswichHospital

14:00 Verification of advanced treatment techniques MrGeoffBudgell TeamLeaderforVerificationandDosimetry, TheChristieNHSFoundationTrust

14:30 On set imaging: from 2D to 3D and beyond MrAndrewReilly ConsultantClinicalScientist,ClatterbridgeCancerCentre

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15:00 Refreshments

15:30 Radiobiologic modelling in gynaecologic cancer DrAlexandraStewart ConsultantClinicalOncologist, RoyalSurreyCountyHospitalNHSFoundationTrust

15:50 Flattening filter free (FFF) MrChrisWalker HeadofRadiotherapyPhysics,TheJamesCookUniversityHospital

16:10 Proton radiotherapy MrRichardAmos OperationalLeadforProtonBeamTherapyPhysics, UniversityCollegeLondonHospitalsNHSFoundationTrust

16:30 Questions

16:45 Close of event

_______________________________________________________________________

Certificate of attendance

Thismeetinghasbeenawarded5RCRcategoryICPDcredits.

Yourcertificateofattendancewillbeemailedtoyouwithinthenexttwoweeksonceyouhavecompletedtheonlineeventsurveyat:

https://www.surveymonkey.com/s/Radiotherapyeducationday

BIR Annual Congress 2015: 4–5 November, London

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Speaker profiles (where supplied)

Mr Richard AmosOperational Lead for Proton Beam Therapy Physics, University College London Hospitals NHS Foundation Trust

RichardAmosisOperationalLeadforProtonBeamTherapyPhysicsatUniversityCollegeLondon(UCL)HospitalsNHSFoundationTrustandHonorarySeniorLecturerattheDepartmentofMedicalPhysicsandBiomedicalEngineeringatUCL.Priortotakinguphiscurrentpositionin2013RichardgainedovertwelveyearsexperienceinprotonbeamtherapyphysicsatbothLomaLindaUniversityMedicalCenterandUniversityofTexasMDAndersonCancerCenterintheUSA.Hiscurrentresearchinterestisinthedevelopmentandclinicalimplementationofadvancedprotonbeamtherapy(PBT)technologyforthetreatmentofcancer.UCLHospitalsaredevelopingoneofthetwofirsthigh-energyPBTfacilitiesintheUKtoservejointlyasanationalPBTservice,duetocommencetreatmentin2018.RichardisaFellowoftheInstituteofPhysicsandEngineeringinMedicine,andservesonanumberofprofessionalcommitteesinboththeUKandUSA.

Mrs Nicola BlacklerLead Dosimetrist Planning and Trials, Derriford Hospital

NicolaBlacklerstartedworkingintheNHSin1989asatraineemedicalphysicstechnicianandonqualificationspecialisedinradiotherapyphysics.In2005sheachievedherMScinradiotherapystudiesandcurrentlyworksasHeadofTreatmentPlanningandMouldRoomwithintheDirectorateofHealthcareScienceandTechnologyatPlymouth.SheisnowthejointvicechairoftheBIRRadiotherapyandOncologySpecialInterestGroup.

Mr Geoff BudgellTeam Leader for Verification and Dosimetry, The Christie NHS Foundation Trust

GeoffBudgellisTeamLeaderforVerificationandDosimetryattheChristieNHSFoundationTrust.HespentfouryearsinaresearchroledevelopingIMRTinitsearlydays,includingthefirstdeliveryofIMRTintheUK,beforemovingintoamoreclinicalrole.

Geoff’sresearchinterestscentreonthedeliveryandverificationofmoderncomplexradiotherapytechniquesandtheadaptationofradiotherapyimagingsystemsforqualitycontrolandverificationpurposes.Heisparticularlykeenonputtingtheresultsofresearchtopracticalpurposeswhichhasresultedintheintroductionofnewandmoreefficientradiotherapyqualitycontrolmethods.

Morerecentlyhehasbeeninvolvedinsettinguptwosatellitecentres,introducinglarge-scaleuseofVMATattheChristie,settingupaQCprogramforFFFbeamsandisstartingtoworkonQAaspectsoftheMRlinac.

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Mr Jamie FairfoulHead of Radiotherapy Planning,Peterborough and Stamford Hospitals NHS Foundation Trust

JamieFairfoulisHeadofTreatmentPlanningatPeterboroughCityHospital,asmallbutverybusydepartmentwithextensiveexperienceofadvancedIMRTandIGRT.

Dr Martin HighleyConsultant Oncologist, Plymouth Oncology Centre, Derriford Hospital

MartinHighleyisaConsultantMedicalOncologistatDerrifordHospital,Plymouth,managingpatientswithmelanoma,renalcellcarcinoma,andovarianandtesticularcancers.HetrainedatGuysHospital,LondonandTheNorthernCentreforCancerTreatment,Newcastle.Hehasaninterestinthepharmacologyofanti-canceragents.

Ms Hayley JamesHead of Radiotherapy Physics, Ipswich Hospital

HayleyJameshasbeenaphysicistatIpswichHospitalsince1999,havingtrainedpreviouslyatSheffieldandthenworkedasaradiotherapyphysicistattheChristie.ShehasbeenHeadofRadiotherapyPhysicsatIpswichHospitalsince2010.Shehasalwayshadparticularinterestsinimplementingnewtechnologies,suchasIMRTandVMATandmorerecentlySABR,aswellasradiotherapyclinicaltrials.SheisamemberoftheNPLRadiationDosimetrySteeringGroup,IMPORTTrialManagementGroupandattendsRTTrialsQAmanagementgroupmeetings.

Mr Andrew ReillyConsultant Clinical Scientist, Clatterbridge Cancer Centre

AndrewReillyisaConsultantClinicalScientistintheradiotherapyphysicsdepartmentattheClatterbridgeCancerCentre.Hisprimaryroleistosupporttheclinicaluseanddevelopmentofradiotherapyimagingtechnologiesandworktowardsimprovedsystemsintegration.Hehasaparticularinterestinbridgingthegapbetweendifferentimagingdisciplinesandoptimisingimagingacrosstheradiotherapyprocess.HeisfounderoftheIQWorksproject,leadstheRadiotherapyImagingUserGroupandprovidedphysicssupportunderthenationalNRIGmentoringprogrammeforIGRTimplementation.AndrewservedasChairmanoftheBIRRadiation,PhysicsandDosimetryCommitteeuntil2009,wasamemberofBIRCouncilfrom2010to2013andrepresentstheBIRontheDHMedicalPhysicsExpertworkinggroup.

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Dr Alexandra StewartConsultant Clinical Oncologist, Royal Surrey County Hospital NHS Foundation Trust

AlexStewartwenttomedicalschoolatSouthamptonUniversity.ShedevelopedaninitialinterestinoncologyattheRoyalMarsdenHospitalworkingonprimarypreventionofbreastcancerstudiesintheProfessorialunit.ShethencommencedspecialistregistrartrainingatCharingCrossandtheHammersmithHospitalswhereamongstotherinterestsshegainedinitialexperienceinbrachytherapy.ShewasthenchosenforaprestigiousFellowshipattheBrighamandWomen’sHospital,HarvardUniversityinBostonwhereshecompletedayearofbrachytherapytrainingandayearofprostatecancerFellowshiponaNationalInstituteofHealthgrant.WhilstthereshewonanASCOmeritawardforaprostatecancerstudythatwassubsequentlypublishedintheJournalofClinicalOncology.

ShereturnedfromtheUSAtocompleteherspecialistregistrartrainingattheRoyalMarsdenHospitalwhereshecontinuedtopublishonspecialistradiotherapytechniquessuchasIMRTinlowerlimbsarcomas.OncompletingherspecialisttrainingshechosetoworkinGuildfordowingtotheexemplarybrachytherapydepartmenttheyhad.Alexhasnowdevelopedtheircervixbrachytherapyandaddedoesophagealandrectalbrachytherapytotheportfolio,oneoffewinternationalcentrestoperformthis.Alexhasastronginterestintheclinicalapplicationsofradiobiologyinbrachytherapyandhaswrittenthreetextbookchaptersonthissubject,inadditiontopublishedpapers.

Alexhaskeptherresearchlinksstrong,holdinganhonorarycontractattheUniversityofSurreyasaVisitingProfessor.SheisleadingastudyoncervixIMRTandanotherontheuseofPETscanninginearlycervixcancer.Sheisalsodevelopingimprovedimagingtechniquesincervixbrachytherapyandcollaboratingwiththeuniversityphysicsandengineeringdepartmentsininnovativeprojects.

SincestartingattheRoyalSurreyin2008,Alexhastakenakeeninterestinmanagement,takingontheroleofRadiotherapyLeadin2010andbecomingClinicalDirectorfortheOncology,MedicalPhysicsandNuclearMedicineDirectoratein2012.SheisnowClinicalLeadforOncology.

Mr Chris WalkerHead of Radiotherapy Physics, The James Cook University Hospital

ChrisWalkerstartedhiscareerinmedicalphysicsin1987employedbytheRegionalMedicalPhysicsDepartmentasabasicgraderadiotherapyphysicistatNewcastleGeneralHospital.HeispresentlyaConsultantClinicalScientistandHeadofRadiotherapyPhysicsatTheJamesCookUniversityHospitalinMiddlesbrough.HehasawealthofexperiencebothintheUKandabroadinthedevelopmentanddeliveryofradiotherapyfromthegroundup.Hehasprovidedstrategicadviceandsupportathomeandoverseastohealthdepartments,radiotherapydepartmentsandprivatecompanies.In2011hewasformallyelectedaschairoftheNorthofEnglandCancerNetworkRadiotherapyCrossCuttingGroup(CCG),whichhasresponsibilityforthedevelopmentofcoordinated,cohesiveandintegratednetworkedcancerservicesforradiotherapy.AdditionallyheistheNorthEastsenaterepresentativeontheRadiotherapyClinicalReferenceGroup.

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Dr Tim WoodClinical Scientist, Hull and East Yorkshire Hospitals NHS Trust

TimWoodworksasaRadiationProtectionandDiagnosticImagingPhysicistintheRadiationPhysicsDepartment,HullandEastYorkshireHospitalsNHSTrust,andisalsoacurrentmemberoftheIPEMDiagnosticRadiologySpecialInterestGroup.Timiscurrentlyleadinganumberofprojectsinvestigatingthedevelopment,implementationandoptimisationofX-rayimagingtechniquesinradiotherapy.Otherinterestsincludethephysics,technologyandclinicalapplicationofCTanddigitalX-rayimaging,includingmammography.

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Abstracts (where supplied)

Setting up the treatment unit: intelligence-guided QCMr Geoff Budgell

Qualitycontrolisoftenconsideredadullnecessity,preferablylefttosomeoneelsetodo.Theaimofthistalkistodemonstratethat,ifyourbrainisengaged,QCcanbeinteresting.ItwillalsoshowhowQCneedstobeconstantlyadaptingtotheever-changingchallengesofradiotherapyincludingnewtechnologies(suchasIGRT,FFF,stereotactictreatmentsandMRlinacs)aswellason-goingclinicaldemandsontheservicesuchasextendedworkinghours,in vivodosimetryandpatient-specificverificationforcomplextreatments.

Thepresentationwilladdressthequestions:• HowdowedecidewhatQCtodo?• HowdowedecideontolerancesandfrequenciesforQCtests?• Dowehavetofollowreportsandrecommendations?• Whatdoyoudowhenimplementinganewtechniqueorpieceof

equipment?• WhoshoulddoQC?• WhattodowhenaQCtestisoutoftolerance?• WhenshouldQCbecarriedoutandhowdowecopewithincreasing

complexityofequipmentwithoutincreasingthetimetakenforQC?• HowdoesQCrelatetoclinicalpracticeandevidence?

Imaging in radiotherapy: current options availableDr Tim Wood

Imagingplaysafundamentalroleatallstagesofthepatientpathwayinastate-of-the-artradiotherapycentre,beittheinitialdiagnosis,treatmentplanningscansorverificationimaging.Forthisreason,theuseof‘imageguidedradiotherapy’shouldnowbeconsideredtobethestandardofcareforalltreatments,ratherthanalimitedspecialistapplication.However,therearemanyoptionsavailableforacquiringimagedatathatcaninformdecisionsregardinganindividualpatient’streatment,witheachmodalityhavingspecificadvantagesanddisadvantages.Itisthereforeimportanttounderstandhoweachimagingtechniqueworkstoensurethebestpossibleoutcomeforthepatient.

Thepurposeofthistalkistooutlinethevariousimagingoptionsthatarecurrentlyavailableinthestate-of-the-artradiotherapycentre.Theseinclude,butarenotlimitedto,CT,conebeamCT,PET–CT,MRIandultrasound.Abriefoverviewoftheprinciplesandbenefitsofeachtechniquewillbepresented,alongwitharangeofissuesthatshouldbeconsideredwhenimplementingthesetechnologies.

Learningobjective:Acquireanunderstandingofthecurrentoptionsforimaginginradiotherapy,andtheadvantagesanddisadvantagesofeachtechnique.

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Chemotherapy: principles and new developmentsDr Martin Highley

Chemotherapeuticagentshavebeenusedtotreatcancersince1946.Theyactbyinterferingwithcelldivision,primarilybyaffectingDNAreplication.Theyareclassifiedintofivegroups;alkylatingagents,platinumcompounds,antimetabolites,topoisomeraseinteractingagentsandantimicrotubuleagents.Theinhibitionofrapidlydividingcellscanleadtothedevelopmentofparticulartoxicities,suchasbonemarrowsuppression,stomatitis,diarrhoeaandalopecia.Theuseofchemotherapeuticagentsneedstobebalancedagainsttheirtoxicities.

Chemotherapy,likeradiotherapy,isusedindifferentsetting—neoadjuvant(priortosurgery),adjuvant(aftersurgery)andinthetreatmentofmetastaticdisease.

Theassessmentofresponseisimportantwhenusinganti-cancertreatments,andtheRECISTcriteriaarewidelyemployedtoassessradiologicalresponse.Otherindicatorsoftheeffectivenessofchemotherapyarethesurvivalofpatientsandthetimetothedevelopmentofprogressivedisease.Theeffectonqualityoflifeisfrequentlyevaluated.Clinicaltrialsareasignificantaspectoftheuseanddevelopmentofsystemictreatments.

Systemictreatmenthaschangedimmenselyinthe21stcenturywiththeintroductionoftargetedtherapies.Thesecomprisetwomaingroups:thesmallmolecules,whichinhibitsignaltransduction,andtheimmunotherapies.

Learningobjective:Tounderstandthemechanismsofaction,clinicaluseandtoxicitiesoftheclassicalchemotherapeuticagentsandthenewertargetedagentsandimmunotherapies.

Target volume definitionMr Jamie Fairfoul

Goodtargetvolumedefinition(TVD)isthefoundationonwhichaccurateradiotherapyisbuilt.Withoutaccuratetargetoutlines,theprecisionaffordedbymodernIMRTandIGRTcannotbefullyutilised.AlthoughthistalkcannothopetocovertheintricaciesofTVDforallclinicalsites,itwillexplainthekeyprinciplesofgoodpracticethatshouldbeusedforallcontouring.

Learningobjectives:

• Accuracyincontouring •Whyisitimportant? •Impactontreatmentquality

• Optimisingyourmaterials/environment

• OptimalimagingforTVD

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• Useofmultimodalityimaging/imagefusion •Appropriatechoiceofimagingmodality •Accuracyofadditionalimagingtechniques •Assessingimageregistration

• Consistency:howdowemeasureitandhowdoweachieveit? •Whatisthecorrectanswer? •Theimportanceofoutliningprotocols?

Basic and advanced treatment planningMs Hayley James

Theradiotherapytreatmentplanningprocessdeterminesthemostappropriatewayofirradiatingapatienttomeettheclinicalrequirementsofthetreatment.Creatingoptimaltreatmentplansforagivenclinicalsitereliesonanumberofprocessesthatinclude:• Determinationofpatientpositionandsuitableimmobilisation• Accuratetargetvolumeandorganatrisklocalisationanddelineation• Determinationofsuitablebeamarrangements(forwardplanning)orthe

requireddoseanddosevolumeconstraints(inverseplanning)• Accuratedosemodellinganddosecomputationmethods• Evaluationofdosedistributions• Determinationoftherequiredtreatmentmachinesettingstodeliverthe

resultantplan

Thistalkwillconcentrateonthefundamentalsofforwardandinverseplanninginrelationto3Dconformalradiotherapy,IMRTandVMAT.Considerationwillbegiventobeamandfluenceshaping,planoptimisation,dosecalculationanddoseevaluation.Methodsofbeammodellinganddosecomputationwillalsobediscussed.

Verification of advanced treatment techniquesMr Geoff Budgell

Overthelastfewyears,theuseofadvancedradiotherapytechniquessuchasIMRT,VMATandSABRhasmushroomedintheUK.Theincreasedcomplexityofthetechniqueshasledtotheadoptionofpatient-specificverificationsonalargescale.Thistalkwillconsiderwhatverificationisactuallyfor,lookatthemeasurementoptionsavailableanddescribetheanalysismethodscommonlyused.Pitfallsinmakingandanalysingmeasurementswillbeidentifiedandadvicegivenonselectingtolerances.

Asnumbersincrease,andasadaptiveplanningbecomesaclinicalreality,manydepartmentsareaskingwhetherpatient-specificverificationsarerequiredforeverytreatmentplan.Thisquestionwillbeaddressed,identifyinghowwecansafelymoveawayfrompatient-specificmeasurementsandwhatsystemshavetobeinplacetoallowthistobecarriedout.

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On set imaging: from 2D to 3D and beyondMr Andrew Reilly

Treatmentplanningisonlythestartoftheradiotherapypatient’sjourney.Althoughagreatdealofeffortisexpendeddevelopingtheoptimumplantailoredtotheindividualpatient’scircumstances,itisimportantthattheplanbeconsistentlydeliveredasintendedoverthesubsequentcourseoftreatment:whetherduringasinglefractionorovermanyweeks.Verificationimagingatthepointoftreatmentisanimportanttoolforensuringsafeandconsistentradiotherapydeliveryovertime.

Thispresentationexplorestheimagingcapabilitiesofmodernradiotherapytreatmentunits,trackingtheevolutionfrom2DplanarMVandkVimagingthrough3Dcone-beamCT(CBCT)volumetricimaging,2D/3Dhybridimagingand4DCBCT.Advancedapplicationsbeyondbasicverificationimagingarealsoconsideredincludingstrategiesforplanadaptationandin vivo dosimetryusingelectronicportalimagingdevices(EPIDs).Thepotentialofemergingtechnologiessuchasimplantedradio-transpondersandreal-timetrackingisdiscussed.

Whenworkingwithstateofthearttechnology,andparticularlytechnologyinvolvingautomationandadvancedcomputersystems,itisimportanttomaintainfocusontheclinicalendpointandavoidbecomingdistractedbytheIT.Methodsforensuringtechnologyisutilisedaseffectivelyaspossibleareconsidered,includingoptimisationofimagingprotocols,peerreviewthroughmulti-centreauditandautomaticcalculationofsetuperrorsandmargins.

Radiobiologic modelling in gynaecologic cancerDr Alexandra Stewart

Historicallybrachytherapydosesweredevelopedempirically,changingdoses(durationofimplant)accordingtotumourresponse,earlyandlatetoxicity.Inthiswaylowdoserate(LDR)brachytherapydoseswereestablished.Doseprescriptionwasestablishedtofixedgeometricpointsinthe1930sandduetotheireffectivenesswerechangedverylittleforover70years.NormaltissuetoxicitywaspredictedbyusingICRUreferencepoints,againwithoutreferencetoactualorganlocation.

Theadventofhighdoserate(HDR)brachytherapyemphasisedtheimportanceofradiobiologyingynaecologiccancer,withuseofradiobiologicmodellingtoconvertdosesfromLDRtoHDRandtopredicttoxicity.Duetounavailabilityofradioactivesources,LDRusehasdeclinedandbeenreplacedbyHDRorpulsedbrachytherapy(PB).AgainradiobiologicmodellinghasbeencriticalinPBtodeterminewhatdosesarerequiredgivendurationofpulseandintervalbetweenpulses.

Gynaecologicbrachytherapyhasnowdevelopedfrompointdosingtovolumebasedprescription.Thisallowsradiobiologytobeusedtoaccuratelydetermine

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thedosesadministeredtotumourandnormaltissuesandhasresultedingreaterratesoflocalcontrolandthuscurewithlowerlatetoxicity.Thispresentationwillexaminebasicradiobiologicprinciplesandshowhowtheyhavebeenusedtodevelopmoderngynaecologicbrachytherapy.

Flattening filter free (FFF)Mr Chris Walker

Thispresentationexplorestheclinicalimplementationofflatteningfilterfree(FFF)technologyinMiddlesbroughwiththeElektalinearaccelerator.DelegateswillgetaninsightintowhatisrequiredtoconvertaconventionallinactoutiliseFFFtechnology.TheElektaimplementationphilosophywillbecontrastedwiththatofVarianandthedifferencebetweenclinicalbeamsofthesamenotionalenergyfromthetwomanufacturerswillbeexplained.Radiationsafetywillbediscussedinrelationtothesignificantlyhigherinstantaneousdoseratesachievedwiththeseradiationbeams.

OnceFFFhasbeenenabledthecommissioningprocesswillbeexploredwithparticularemphasisontheabsolutedosecalibrationmethodology.ThisisofparticularimportanceaspresentlyaUKcodeofpracticeforreferencedosimetryonthesebeamsisstillunderdevelopment.Inordertoconfirmthelongtermvalidityofthecommissioningprocessbaselinequalitycontrolparameterswereestablishedandwillbedemonstratedinthispresentation.

Throughoutthepresentationthepotentialadvantagesofthistechnologyintheclinicalenvironmentwillbediscussedincludingthereductionofheadscatterandtheenhanceddoserate.ExamplesofclinicalplanswillbepresentedwithdosedistributionsforSABRfornon-small-celllungcancer,hypofractionatedprostatetreatmentsandintracranialstereotactictreatmentsforbrainmetastasis.Dataontreatmentdeliverytimeswillalsobeprovidedtodemonstratetheintrinsicefficiencyofthistechnology.Finallytheimpactthatthistechnologypotentiallyexhibitsintreatmentofleftsidedbreastcancer,underdeepinspirationbreathholdwillbedemonstrated.

Proton radiotherapyMr Richard Amos

Protonradiotherapypotentiallyoffersclinicaladvantagesoverconventionalradiotherapyowingtothephysicalcharacteristicsofchargedparticleinteraction.Asprotonstraversepatientanatomytheyloseenergy,slowingdownandbecomingmoredenselyionisingastheyapproachtheirend-of-range,atwhichpointtheystop.Thismanifestsintodosedepositionasafunctionofdepththatincreasestoamaximum,theBraggpeak,towardstheirend-of-range,withnodosebeyond.BychoosingprotonbeamsofinitialenergysuchthattheBraggpeakregionisdeliveredatthedepthoftheclinicaltargetvolume(CTV),thetherapeuticdosecanberealizedwithreduceddosetosurroundinghealthytissuecomparedwiththatdeliveredbyphotons.Reduceddosetosurroundingtissueoffersthepotentialforreducedacutetoxicityandsecondarycancerrisk.

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Currentstate-of-the-arttechnologicalrequirementsfortheprovisionofprotonradiotherapyarelargescaleandexpensive.Despitethis,however,thepromiseofaclinicaladvantagehasledtoarapidgrowthinavailabilityofprotonbeamfacilitiesworldwideinrecentyears,andsuchtechnologywillsoonbeavailableinEnglandforNHSpatientsindicatedforprotons.

Theeducationalaimsofthispresentationaretointroducetheaudiencetothefundamentalcharacteristicsofclinicalprotonbeams;todescribethetechnologyandlayoutofatypicalprotonfacility;toprovideexamplesofdeliveredtreatments;andtosummarisetheUKprojecttodate.

Thelearningobjectivewillbeanunderstandingoftherationaleforprotonradiotherapy;thetechnologicalrequirements;andfutureofprotonradiotherapyintheUK.

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FORTHCOMING EVENTS

THE SPINE IN HEALTH AND DISEASE21 JANUARY 2015

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CONTRAST STUDY DAY AND ESSENTIAL PHYSICS FOR FRCR29 - 30 JANUARY 2015

SHEFFIELD

RADIOLOGY ERRORS6 FEBRUARY 2015

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EMERGENCY INTERVENTIONAL RADIOLOGY13 FEBRUARY 2015

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EMERGENCY OUT OF HOURS RADIOLOGYAPRIL 2015GLASGOW

MANAGEMENT AND RADIOLOGY - A GUIDE TO CURRENT AND FUTURE MANAGEMENT ISSUES IN RADIOLOGY

1 MAY 2015LONDON

THORACIC IMAGING15 MAY 2015CAMBRIDGE

AN EVENING WITH PROFESSOR LÁSZLÓ TABÁR:A NEW ERA IN THE DIAGNOSIS AND TREATMENT OF BREAST CANCER

18 MAY 2015LONDON

EMERGENCY DEPARTMENT IMAGING MAY 2015

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NEURORADIOLOGY UPDATE AND REFRESHER COURSE18-19 JUNE 2015

LONDON

AN UPDATE IN CLINICAL BREAST MRI23 JUNE 2015

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VISIT: WWW.BIR.ORG.UK FOR MORE INFORMATION AND TO REGISTER

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