Courses and Schedule

This session provides detailed information on how to compare lung stereotactic body radiation therapy treatment with and without the use of the Varian Respiratory Gating for Scanners and Real-time Position Management systems. The speakers will share information on dosimetry, billing, treatment setup, treatment time, patient side effects and patient experience for each treatment technique. The session will increase attendees’ knowledge of the advantages and disadvantages of gated and nongated SBRT treatment and inspire attendees to begin implementing gated SBRT treatments at their organizations.

Jill Achille, M.S., R.T.(T)

Ryan Quirindongo, B.S., R.T.(T)

Objectives

• Identify the similarities and differences between the two techniques.
• Understand the benefits and disadvantages of gated SBRT.
• Understand how the Varian RGSC and RPM systems function.
• Understand how each technique impacts the patient.

In this session, the speakers will discuss their experiences as radiation therapists during the evolution of brachytherapy at Penn Medicine. Attendees will learn about the health system’s new OR procedure suite and how it has improved patient experience by providing accuracy, safety and peace of mind. The speakers will also explore the transformation of therapists' roles at Penn Medicine.

Laura Hesse, M.H.S., R.T.(R)(T)

Kathryn Wisniewski, R.T.(T)

Objectives

• Explore the evolution of brachytherapy and how therapists' roles at Penn Medicine have transformed.
• Describe Penn Medicine's cutting-edge technology, such as intracavitary and interstitial devices, advanced imaging, real-time treatment planning, and how the technology provides unprecedented precision, efficiency and convenience.
• Discuss how the suite's state-of-the-art features have significantly improved patients' experiences.

Health care workers are five times more likely to experience workplace violence than employees in all other industries. In a nationwide survey conducted this year of nearly 1,000 nurses, eight of 10 said they have experienced a high prevalence of racism and discrimination from patients. Disruptive behavior toward health care workers from patients and visitors negatively affects the safety and health of workers and the quality of care they deliver.

In 2020, during the height of the COVID-19 pandemic, the department of radiation oncology at Massachusetts General Hospital recognized this challenge and formed a committee charged with supporting staff who encounter disruptive behavior and addressing the behavior with patients and visitors. The STAND committee is comprised of department leaders who help support the targeted workforce member, train and advise staff on how to respond, notify disruptive persons of behavioral expectations and boundaries, and de-escalate or discharge patients as appropriate.

Courtney Brown, M.H.A., R.T.(T)

Objectives

• Identify strategies to support targeted workforce members.
• Describe the SAFER model to de-escalate situations.
• List disruptive and discriminatory behavior.
• Explain how to create a patient and visitor code of conduct.

In the continuously evolving field of radiation therapy, prioritizing the highest standards of patient care and safety remains paramount. The journey from novice to proficient practitioner is not without its challenges, and bridging the gap between classroom learning and clinical practice is a pressing concern for radiation therapy students and educators. This session aims to offer a fresh perspective on the gradual release of responsibility model, shedding light on its application in the context of educating prospective radiation therapy professionals.

Angela Oliveira, M.P.A., R.T.(T)

Objectives

• Discuss the existing gaps between classroom instruction and clinical procedures and their impact on radiation therapy students’ roles, fostering a deeper understanding of the procedures.
• Explore the relevance of the gradual release of responsibility learning model in the transition to clinical practice, providing attendees with a profound comprehension of its potential.
• Describe various methods of enhancing classroom learning, including skilled labs, interactive demonstrations and educational games, to enrich the educational experience of radiation therapy students.
• Explain the importance of feedback and assessment within the gradual release of responsibility model, illustrating their potential to evaluate learning and enhance student outcomes.

In rapidly changing workplaces, radiation therapists have increasing responsibility for correct charge capture and documentation. Incorrect information obtained internally or externally could result in missed or improper billing and loss of department income. Policies from third-party payors change frequently, and what is documented and captured today can quickly be on tomorrow’s list of what not to do. This session reviews industry standards and explores resources for authoritative guidance to help attendees establish a filter for gathering advice and direction from various sources.

James E. Hugh III, M.H.A., ROCC

Objectives

• Explore the quickest and best methods for documentation.
• Understand the importance of knowing the correct procedure codes for each procedure performed.
• Discuss current regulations governing who should supervise procedures to appropriately protect facilities and patients.
• Describe how to capture correct codes for both the hospital and physicians.

The radiation oncology department at Penn Medicine – Chester County Hospital is a highly advanced facility treating upwards of 60 patients a day. In 2022, Penn Medicine purchased the Varian Ethos, an adaptive radiation therapy treatment unit. This session overviews the purchasing process, time leading up to installation, and the training used to create the personalized and efficient new workflow process. The speakers will review their step-by-step process to safely and efficiently use the new technology and advance their skillset. Attendees will learn how to evaluate patient specific characteristics and how to ensure the selected patients are proper candidates for adaptive therapy. Adaptive therapy is not perfect for everyone, and the decision-making process starts with the radiation therapist at the time of computed tomography simulation. The speakers will also share how their department created an efficient workflow while maintaining the highest level of safety.

Daniel Roberts, M.B.A., R.T.(R)(T)

James Michael Murry, B.S., R.T.(T)

Objectives

• Overview the Penn Medicine – Chester County Hospital radiation oncology department’s structure and what led to the decision to purchase a new linear accelerator with adaptive therapy.
• Analyze and explain the planning, development and implementation of the Ethos treatment unit including the go-live process.
• Examine the new workflow education, including how it was created, implemented and improved through multiple failure mode and effects analysis discussions.
• Review how workflows were sustained in a large, busy department using multiple resources including physician, physicist, nurse, therapist and dosimetrist.
• Discuss the overall plan for the department to learn and grow for the future of adaptive therapy.

This course overviews prone breast setup and the treatment process. Attendees will improve their knowledge of breast anatomy, breast cancer staging, genetic testing, partial vs. whole breast radiation therapy and treatment techniques. The speaker will discuss the advantages of prone vs. supine breast radiation treatments, the type of patients who may benefit from prone position treatments, prone breast immobilization device setup and positioning of patient during simulation. Attendees will also learn about prone breast treatment planning, the treatment process and patient experience.

Sireesha Kavipurapu, Ed.D., R.T.(R)(T)

Objectives

• Understand breast anatomy and breast cancer staging.
• Understand advantages of prone position radiation treatments.
• Learn how to set up prone breast immobilization device.
• Identify types of patients that are candidates for prone breast treatments.
• Refresh knowledge on breast cancer.

According to the Centers for Disease Control and Prevention, the health care and social assistance sector exhibits among the highest rates of workplace-related injuries. A 2020 study conducted by Macavei and Clark surveyed 401 medical imaging and radiation therapy professionals and found that more than half, or 62.6%, experienced occupational injuries. Many of these injuries are musculoskeletal disorders, which may arise from overexertion when manually lifting or transferring a patient. The adoption of safe patient handling techniques using assistive devices is effective in reducing the risk of injuries among health care workers and patients. Although safe patient handling practices exist, most therapists do not typically receive appropriate training and no patient mobility assessment tool is widely adopted in the outpatient setting.

The radiation therapy team at Mount Sinai Hospital recently experienced an increase in workplace injuries and identified a gap in workplace safety and training. In collaboration with occupational and ergonomic safety staff, the speakers initiated a therapist-led initiative to assess ambulatory patient mobility via the Ambulatory Safety Check. This novel algorithm adapts the inpatient nursing Bedside Mobility Assessment Tool for radiation therapists to use in the outpatient setting.

This session explores Mount Sinai Hospital’s experience in developing and implementing the Ambulatory Safety Check, reviews pre- and post-implementation survey data, and looks at future opportunities for training. Attendees will gain access to this novel algorithm and key safe patient handling resources.

Mark Roytman, B.S., R.T.(T)

Vincent Gazzara, B.S., R.T.(T)

Objectives

• Review workplace injury trends among medical imaging and radiation therapy professionals.
• Identify best practices for safe patient handling in radiation therapy, including the appropriate use of assistive devices and assessing patient mobility.
• Discuss the importance of safe patient handling practices among radiation therapists to reduce staff and patient injuries and review the principles of the Ambulatory Safety Check tool.
• Describe the elements of a successful safe patient handling program as defined by the Occupational Safety and Health Administration, including commitment from management, assessment, technology and prevention, education and training.

This course overviews how alternative teaching modalities in the classroom setting can lead to greater retention of challenging material. The speakers will demonstrate various engaging modalities, such as mock patient setups, adaptation of competitive games (e.g., Jeopardy!, Trivial Pursuit, Wordwall, Kahoot!), book discussions, book clubs and TED Talks. These teaching strategies can help reinforce challenging academic course work in medical imaging anatomy, radiation physics, ethics, and clinical procedures in student practicum, among other topics. Attendees will learn about findings which indicate that these methods keep students engaged, encourage a sense of camaraderie with their classmates and create a more comfortable atmosphere where students feel supported.

Alisa Kagen, M.S.A., R.T.(T)

Jeannetta Greer, M.Ed., M.S., R.T.(T)

Objectives

• Identify how to engage students for greater retention of challenging material.
• Demonstrate unique additions to classroom instruction.
• Explain how to support students in clinical practicum through classroom discussions and mock patient setups.
• Explore how student engagement positively impacts success in courses and supports university goals of retention after graduation.
• Describe how to promote more classroom discussions.
• Understand how to use new teaching modalities to present registry review material.

This course reviews billing and coding applicable to radiation oncology for 2024. The speaker will discuss applicable codes and associated documentation and compliance. Attendees will learn how the rules are made and how to modify and edit existing rules through legislative efforts.

Ron DiGiaimo, M.B.A., FACHE

Objectives

• Understand the importance of correct coding for radiation therapy.
• Understand the differences in stereotactic radiosurgery, intensity-modulated radiation therapy, brachytherapy, stereotactic body radiation therapy and pharmaceutical coding for radiation oncology.
• Discuss how to reduce the compliance risk of incomplete documentation.
• Describe how to improve radiation therapy departments’ financial performance.

This course overviews the use of image-guided superficial radiation therapy in dermatological settings for treating nonmelanoma skin cancers. The speaker will discuss the science behind superficial radiation therapy, its applications, its effects on the skin and the range of treatable conditions. Attendees will learn about patient education strategies, analysis of peer-reviewed journal studies, clinical applications, and insights into educational approaches for students and therapists.

Rachel Ward, B.S., R.T.(T)

Objectives

• Discuss the responsibilities of a radiation therapist in a dermatology office.
• Identify the different types of skin cancers that can be treated with SRT.
• Explain the fundamentals of operating an SRT unit.
• Describe the treatment and career path to colleagues and patients.

This course enhances radiation therapists’ knowledge of techniques that aid in decreasing the treatment anxiety of pediatric patients undergoing radiation therapy. At Cincinnati Children’s Proton Treatment Center, therapists help borderline pediatric patients tolerate treatments without sedation by changing their treatment masks from a scary immobilization device into something that transforms them into a superhero, unicorn or a favorite cartoon character. This can divert their focus from the scary surroundings of the treatment bay into something fun and inspiring. The speaker will provide step-by-step instructions of this process.

Dale James, R.T.(R)(T)

Objectives

• Describe how to use audio or video distraction techniques to aid in calming pediatric patients and enabling them to be treated without sedation.
• Explain nontechnological methods to distract pediatric patients from treatment anxiety.

This course offers specific guidance for educating radiation therapy interns. The speaker will discuss current issues facing students, valuable tools for clinical educators and what to do when students need extra assistance. Attendees will also learn about burnout in educators and how to combat this type of burnout in the clinic.

Amanda Carpenter, M.S.Ed., R.T.(T)

Objectives

• Describe issues facing radiation therapy students.
• Discuss learning plans for students who are struggling in clinic.
• Explore issues attendees are facing with students in clinic.
• Identify tools to help students be successful and to address burnout in educators.

With any collaborative endeavor — be it treating a patient, organizing a committee or implementing a system change — leadership is a crucial component to staying on track and on time and getting it done right. But what if you’ve been asked to lead and you are afraid to take the reins? What if you yearn to assume a more prominent role on your team, but you are unsure of your abilities to lead and make decisions? This course explores core leadership concepts and techniques, with a special focus on those who are eager, but reluctant, to lead. The speaker will describe obstacles to success, such as self-sabotage, anxiety and self-doubt, and will help attendees conquer those obstacles with a plan to increase confidence and cultivate success. Additionally, the speaker will discuss common leadership pitfalls, how to avoid them and how to address and recover from mistakes. This course will be engaging and interactive, with active demonstrations and live polls and quizzes.

Joseph Bender, R.T.(R)(T)

Objectives

• Identify core leadership concepts.
• Discuss how to remove impediments to successful leadership.
• Describe strategies to deal with and resolve conflict in a team dynamic.
• Explain different leadership styles and how to find a style that works for you.
• Create a plan for accountability and evaluation for yourself and your team members.

This course offers guidance on how to use breath hold for stereotactic body radiation therapy treatments for lung and abdominal lesions using surface tracking technology such as SimRT and AlignRT systems. The speaker will discuss how their organization designed and evaluated SBRT workflow, which encompasses patient selection criteria, computed tomography simulation, treatment planning and treatment day. Attendees will learn how to create buy-in at their organizations, design a workflow that therapists are comfortable with, and work with the physicians and physicists to achieve anticipated outcomes.

Jotsna Singh, B.S., R.T.(R)(T)

Objectives

• Identify the form of breath hold available in attendees’ clinics that would allow for accurate tracking.
• Discuss how to develop a training path for radiation therapists.
• Understand the reasoning behind the multiple breath-hold CT scans.
• Participate in the evaluation or treatment workflow and improvement outcomes.
• Determine the next steps: who needs to be involved at your clinic to achieve breath-hold stereotactic body radiation therapy if it’s not already in use.

Effective patient care lies at the heart of patient experience. As vital members of the health care team, radiation therapists hold a key role in delivering radiation treatments. The ASRT and American Registry of Radiologic Technologists recognize the importance of patient care principles and emphasize their significance in the radiation therapist’s role. However, defining patient care for students or seasoned radiation therapists and training them in these principles can be challenging, with limited literature examples on how to acquire or enhance these skills. The evolving role of the radiation therapist in research highlights the connection between improving radiation therapy outcomes, patient care skills and overall patient experience. This course unlocks the potential of radiation therapists in advancing patient care through research and features discussion of various research projects. The first explores evidence-based patient care training. The second introduces sensitive practice training grounded in trauma-informed care, focusing on survivors of sexual violence undergoing radiation therapy, with a universal precaution approach.

This course seeks to bridge the gap between patient care, training and research, to empower radiation therapists to champion person-centered care. Attendees will gain tangible tools to influence treatment outcomes through enhanced patient care, ultimately making a meaningful contribution to the advancement of the profession.

Maria Dimopoulos, Ph.D., M.B.A., R.T.(T)

Objectives

• Define principles of patient care and patient-specific needs.
• Discuss the role of the radiation therapist in providing effective patient care.
• Explain the connection between research, patient care and treatment outcomes.
• Describe sensitive practice guidelines as a universal precaution.

On Oct. 23, 2023, the Windsor Regional Cancer Centre was a victim of a mass cyberattack that affected multiple health care facilities and services in Windsor-Essex County in Ontario, Canada. A majority of electronic systems were inaccessible, including electronic medical records, treatment-planning systems and radiation treatment delivery records. For two weeks, radiation delivery services were paused, as it was not possible to retrieve patient information or deliver emergent and urgent radiation therapy treatments.

The Windsor Regional Cancer Centre services a region of more than 400,000 people, and there was no end in sight for when its systems would be operational again. With the closest Canadian radiation therapy department two hours away, it became imperative that the center create a delivery method for emergent and urgent palliative patients. This session overviews how the center shifted to manual treatment delivery and paper charting to provide care during the outage.

Henna Parmar, M.Sc., MRT(T)

Objectives

• Identify how to detect cases appropriate for manual treatment delivery.
• Describe how to reproduce individual paper charts and corresponding paper treatment delivery records.
• Explain manual treatment delivery methodology.

Ultrasound imaging has been used in health care, including in radiation therapy, for more than 60 years. This course enhances attendees’ understanding of ultrasound use in the radiation therapy setting. The speakers will describe the development and history of ultrasound and how it found its place in medicine. Attendees will learn how ultrasound imaging is used in radiation therapy, from cancer detection and ultrasound guidance in prostate cancer and other soft tissue cancers to its use in the dermatology setting for targeting nonmelanoma skin cancers. The course will conclude with a discussion on how ultrasound imaging could be used in the future for cancer detection and localization for daily cancer treatment in radiation therapy.

John Klade, B.S., R.T.(T)

Rachel Ward, B.S., R.T.(T)

Objectives

• Explore the development and history of ultrasound.
• List the technological aspects of ultrasound.
• Discuss the use of ultrasound in radiation therapy.
• Describe the future use of ultrasound in cancer diagnosis and treatment.

Recent clinical advancements suggest an increased use for intraoperative brachytherapy in the routine treatment of pancreatic cancer patients. This course describes the emerging role of radiation therapy professionals in intraoperative brachytherapy procedures to develop safe, high-quality radiation therapy delivery. The speaker will highlight the radiation therapist’s role in clinical workflow implementation in the operating room. Attendees will gain an appreciation for a multidisciplinary approach to developing a higher-quality intraoperative program in a quickly advancing clinical setting.

Georgia Paparoidamis, B.S., R.T.(R)(T)

Objectives

• Discuss the workflow of intraoperative brachytherapy.
• Explore the development of the radiation therapist’s role in intraoperative brachytherapy.
• Describe the clinical importance of using brachytherapy in the treatment of pancreatic cancer.
• Explain the radiation therapist’s role in the setting of intraoperative brachytherapy.

The term opioid crisis is used daily in the United States. When the prevalence of these drugs soared in our society, the Centers for Disease Control and Prevention created updated prescribing guidelines. After publishing these general recommendations, many states used them to hastily pass new laws and restrictive regulations in 2016. Now, after eight years and a global pandemic, it’s important to look at where this crisis stands. This session explores the true scope of the opioid crisis. The speaker will discuss if more laws are necessary and what the impact of this crisis is on the patients with cancer who need these medications.

Zachary Smith, M.B.A., R.T.(R)(T)

Objectives

• Explore the true scope of the opioid crisis.
• Understand the main drivers of the increase in opioid-related deaths.
• Discuss the impact legislation has had on access and drug overdoses.
• Describe successful tactics that are driving down death rates.

Change is one constant in the radiation oncology profession. Changes in people, processes, technology and governance can have lasting impacts on departmental culture, safety and practice. Studies suggest that approximately 70% of change initiatives are unsuccessful, often due to the lack of change management application throughout the planning, communication and implementation of initiatives. Radiation oncology is a fast-paced, complex environment where the focus is often on implementing the newest technology, equipment and processes, with less focus on communication and training strategies for the interprofessional teams impacted by the changes. Change management is the implementation of strategies and tools to support people affected by change, from their current state through the transitional phase to the desired future state. This session explores change management definitions, strategies and potential applications in radiation therapy education and clinical practice.

Kristi Tonning, Ph.D., R.T.(T)

Objectives

• Explain John Kotter’s eight steps for successful change and their application to radiation therapy education and clinical practice.
• Describe factors that impact organizational change and how changes affect organizational culture and safety.
• Explore the role of planning, communication and training strategies in process improvement for successful change management.
• Discuss the tenets of change management and the tools and techniques applicable to change management in radiation oncology.

This course describes the benefits and barriers to using auto beam hold triggered imaging for hypofractionated high dose prostate treatments with the use of fiducial markers for image guidance and accuracy. Daily cone-beam computed tomography imaging is commonly exclusively used to review overall anatomy and critical structures within contours. CBCT can visualize anatomy, however, soft tissue contrast is not always optimal. Fiducial markers help eliminate the degree of uncertainty associated with soft tissue alignment, and auto beam hold triggered imaging provides an opportunity to make corrections throughout treatment, allowing for improved accuracy. Without fiducial markers, there is user unpredictability, which can generate varying set up corrections and shifts depending on the therapist.

This course uses case studies to compare traditional techniques for prostate treatment using daily CBCT with ABH triggered imaging techniques. The speaker will share her experience implementing an ABH triggered imaging protocol at Mount Sinai West and describe how it minimizes the uncertainty of total prostate motion and enhances efficiency and the quality of patient care. Attendees will learn about the need for a multidisciplinary approach and best practices to implement this protocol in their departments and discover key takeaways about this protocol.

Samantha Cariello, B.S., R.T.(T)

Objectives

• Describe the use of auto beam hold in prostate treatment.
• Discuss quality of treatment for prostate cancer.
• Explain auto beam hold with high dose prostate treatments.

Cherenkov imaging, an innovative technology that displays the live beam directly on a patient’s skin, has introduced significant changes to treatment workflows. Central to this transition is the need for complete exposure of the treatment area to ensure the Cherenkov signal is effectively detected by the specialized cameras. This course introduces Cherenkov imaging technology and explores the implications of required changes in workflow, focusing particularly on therapists’ use of the technology and how these changes may also affect the patient. Beyond its immediate workflow modifications, Cherenkov imaging holds the potential to optimize patient outcomes by providing real-time feedback. Therapists encounter new procedural demands, adjustments in the console area and the necessity for additional training. Conversely, patients experience increased exposure of the treatment area, which may influence their comfort and overall experience during sessions. It is essential to note that not all clinics operate identically, and the adoption and adaptation of Cherenkov imaging requires variation based on individual clinic conditions and priorities. Evaluating these workflow modifications and possible solutions, coupled with the potential for enhanced patient outcomes, is vital to comprehend the broader implications of integrating Cherenkov imaging into radiation therapy practices.

Rory Rosselot, B.S., R.T.(T), CMD

Objectives

• Explain specific conditions required for successful Cherenkov imaging.
• Describe where workflow adjustments may be required.
• Discuss differences from clinic to clinic.
• Apply knowledge of Cherenkov imaging to make clinic-specific workflow adjustments.
• List fundamentals of Cherenkov radiation.

The course informs radiation therapists about the value of identifying and addressing ageism in their departments. Attendees will become knowledgeable about ageism encountered by oncology patients and learn about avenues departments can take to lessen ageism’s impact. The speakers will present research regarding ageism in the radiation sciences.

Timmerie Cohen, Ph.D., R.T.(R)(T), CMD

Melanie Dempsey, Ph.D., R.T.(R)(T), CMD

Objectives

• Define ageism.
• Identify what ageism looks like.
• Describe the consequences of ageism in the cancer population.
• List strategies that may reduce the impacts of ageism.
• Discuss research about ageism in the radiation sciences.

This course discusses the functions of an adaptive radiation therapist in an adaptive clinical setting. Attendees will learn how therapists are trained for adaptive roles, become familiar with daily responsibilities and adaptive radiation oncology workflow, learn about other options that evolve from adaptive roles, and understand what’s needed to perform in a clinical setting. The speakers will also discuss customized training and optimized workflows which have been created to match the cone-beam computed tomography-guided and magnetic resonance imaging-guided adaptive technology. Attendees will learn about opportunities for career advancement. This course is designed not only to equip attendees with the necessary skills for current practice but also to position them as contributors to the future evolution of radiation therapy.

Francis Holgado, A.S., R.T.(T)

Melanie Raaser, B.S., R.T.(T)

Chinasa Okoro, B.S., R.T.(T)

Objectives

• Understand the general functions of adaptive machines.
• Differentiate the role of an adaptive radiation therapist vs. conventional therapist.
• Explore prospective pathways for the future.
• Develop insight into the practice area of adaptive therapy.