International 06 - CT-Guided, MRI-Guided, or Offline Adaptive Radiation Therapy? A Structured, Case-Based Debate on Value, Efficiency and Use across Global Resource Settings
MODERATOR(S)
Tamer Refaat, MD, PhD, MS - Loyola University Chicago
session DESCRIPTION
Adaptive radiation therapy encompasses a spectrum of approaches that have evolved from historically established offline strategies to contemporary online CT-guided and MRI-guided adaptive platforms. Offline adaptive radiation therapy, widely used in routine clinical practice, relies on periodic reassessment and plan modification over days to weeks and typically requires no additional capital investment beyond standard imaging and planning infrastructure. In contrast, online adaptive approaches, whether CT-guided or MRI-guided, enable same-day plan modification at the treatment console but require substantially greater technological, staffing and financial resources. This case-based, debate-style educational session will compare CT-guided online adaptive radiation therapy, MRI-guided adaptive radiation therapy, and offline adaptive strategies using representative clinical scenarios. Through structured point-counterpoint discussions, faculty will examine technical requirements, workflow efficiency, time to adaptation, disease-site-specific indications, and supporting clinical evidence for each approach. Particular emphasis will be placed on value, cost-effectiveness, and feasibility across diverse practice environments, including limited-resource and global oncology settings. By juxtaposing established and emerging adaptive paradigms, this session provides a practical framework to guide adaptive therapy selection based on clinical need, institutional capacity, and equitable access to high-quality care.
learning objectives
- Compare CT-guided online adaptive, MRI-guided adaptive, and offline adaptive radiation therapy approaches with respect to technical requirements, workflow efficiency, time to adaptation, and resource utilization across diverse clinical practice settings.
- Determine appropriate clinical indications for each adaptive radiation therapy approach by integrating disease-site-specific considerations, anticipated clinical benefit, institutional capabilities, and patient-specific factors.
- Apply value-based decision making principles to select and justify an adaptive radiation therapy strategy that balances clinical benefit, operational feasibility, and cost-effectiveness, including in limited-resource and global oncology settings.
Credits
| AMA PRA Category 1 Credits: | 1.00 |
Presentations
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02:15pm - 02:20pm ET
Adaptive Radiation Therapy Across the Spectrum: Historical Foundations, Emerging Technologies, and the Value-Based Debate (5 min intro)
Speaker: Tamer Refaat, MD, PhD, MS - Loyola University Chicago, Chicago -
02:20pm - 02:40pm ET
MRI-Guided Online Adaptive Radiation Therapy: Case-Based Assessment of Precision, Clinical Benefit, and Resource Requirements
Speaker: Percy Lee, MD, FASTRO - City of Hope National Medical Center, Rancho Santa Margarita -
02:40pm - 03:00pm ET
CT-Guided Online Adaptive Radiation Therapy: Case-Based Evaluation of Workflow Efficiency, Scalability, and Implementation Across Resource Settings
Speaker: Lauren Henke, MD, MS - University Hospitals/Case Western Reserve University, Cleveland -
03:00pm - 03:20pm ET
Offline Adaptive Radiation Therapy: Case-Based Strategies for Value-Driven Care Across Diverse and Limited-Resource Settings
Speaker: Kevin Albuquerque, MD - Simmons Comprehensive Cancer Center, UTSW Radiation Oncology, Dallas -
03:20pm - 03:30pm ETSpeaker: Tamer Refaat, MD, PhD, MS - Loyola University Chicago, Chicago