At one academic cancer center, monthly computed tomography simulation cancellations averaged 31% in the breast cancer patient population, leading to treatment delays, avoidable rework and workflow disruptions across therapy, physics, nursing and physician teams. Many cancellations were caused by inconsistent presimulation communication and outstanding clinical items, such as pending staging information, incomplete pathology, unclear surgical timelines, systemic therapy sequencing and variability in how readiness was assessed.

To address these gaps, a team designed and implemented a standardized, high-reliability CT simulation readiness workflow tailored to breast radiation therapy. The model included a structured advanced practice provider-led chart review, a presimulation telehealth readiness visit, standardized in-basket communication and the development of a patient readiness dashboard. This dashboard aggregates key data points, including the consult date, surgery date, projected end of chemotherapy and Oncotype score (if applicable) to identify potential barriers to simulation before they affect scheduling. Following the implementation of this workflow, monthly CT simulation cancellations decreased from 31% to 5%, with corresponding improvements in on-time treatment starts and day-of-simulation efficiency.

In this session, the speaker provides practical tools — including workflow pathways, practical checklists, readiness criteria, dashboard concepts and communication pathways — to help teams standardize CT simulation preparation, reduce variation and improve patient access and safety.

Amber Nguyen, D.N.P., APRN-CNP, AOCNP, B.S., R.T.(R)(M)

Objectives

• Identify common causes of computed tomography simulation delays and cancellations in the breast radiation therapy patient population and describe their impact on workflow, patient access and care quality.
• Describe the key components of a high-reliability CT simulation readiness workflow, including standardized chart review, presimulation telehealth and structured communication pathways.
• Identify practical tools such as readiness checklists, dashboard elements and communication templates to improve efficiency and reduce day-of-simulation delays in the department.

In this course, the speaker provides a comprehensive overview of the current state-of-the-art techniques and clinical implementation of breast irradiation for the management of breast cancer. The speaker will focus on the latest technological and biological advancements, using the guidelines at The University of Texas MD Anderson Cancer Center.

Thomas Jozwiak, B.S., R.T.(R)(T)

Objectives

• Analyze the rationale and evidence supporting hypofractionation and ultrahypofractionation schedules in both the adjuvant and palliative settings.
• Evaluate the role and techniques of accelerated partial breast irradiation.
• Differentiate between modern delivery technologies — such as intensity-modulated radiation therapy and volumetric modulated arc therapy — and simultaneous integrated boost consideration, as well as their application in minimizing dose to organs at risk, particularly the heart and lungs.
• Describe and implement advanced planning and gating techniques, including deep inspiration breath hold, to reduce cardiotoxicity using C-RAD.

In this course, attendees will gain an understanding of the evolution of technology in radiation oncology, with a specific focus on automation, machine learning, deep learning and artificial intelligence. Automation has been embedded in radiation therapy workflows for decades to improve efficiency, accuracy and standardization. More recently, AI-driven tools have expanded these capabilities, influencing treatment planning, image guidance, quality assurance and clinical decision support. In this session, the speaker will explore how each technological phase has impacted clinical workflow, precision, quality control and safety. The speaker will also examine the essential role of patient-centered care, therapeutic communication, and human presence in radiation therapy and critically evaluate whether these aspects of care can be fully replicated or replaced by AI. Attendees will receive clinical context and rationale for why human oversight and compassionate care remain fundamental to radiation therapy practice.

Subramanya Betageri, M.Sc., DRTT, R.T.(T)

Objectives

• Differentiate between automation, machine learning, deep learning and artificial intelligence as applied to radiation oncology.
• Describe the historical evolution of automation in radiation therapy workflows prior to the emergence of AI.
• Recognize increasing levels of automation and AI impact on workflow efficiency, accuracy, precision, quality assurance and quality control.
• Identify the limitations, risks and safety considerations associated with AI-enabled systems in radiation oncology practice.
• Discuss the evolving role of the radiation therapist — including patient-centered care, therapeutic communication and human judgment — in an AI-integrated clinical environment.

A greater focus on the costs of health care, along with technological advances, demands an increase in learning for radiation therapists. With more responsibility regarding appropriate charge capture and documentation, as well as decreases in payments and complicated payer rules, therapists must stay on their toes to prevent losses in reimbursement. Who do you turn to and where can you verify that your current coding process is accurate? In this session, the speaker will review industry standards and explore resources for authoritative guidance on health care billing and coding.

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

Objectives

• Identify the correct radiation therapy treatment and other procedure codes performed and documented under basic charge capture rules.
• Differentiate the correct facility and physician codes to attach to those procedures.
• Define and understand new treatment codes and other coding issues, including the need for efficient documentation.

Low-dose radiation therapy has demonstrated meaningful clinical benefits in the management of osteoarthritis and other benign inflammatory conditions, including pain reduction, improved mobility and decreased reliance on long-term pharmacologic interventions. For patients, this approach offers a well-tolerated, noninvasive option with a favorable safety profile when appropriately applied. Despite these advantages, the implementation of LDRT within clinical settings remains challenging due to regulatory constraints, nascent reimbursement pathways and operational barriers in radiation oncology workflows. Addressing these obstacles is essential to expanding patient access and integrating LDRT into evidence-based inflammatory disease management.

Deborah Carroll-Cesario, A.A.S., R.T.(R)(T)

Objectives

• Understand the benefits of low-dose radiation therapy for benign inflammatory conditions.
• Identify patient-centered outcomes: pain relief, functional improvement and reduced medication burden.
• Discuss strategies to facilitate implementation and broader clinical acceptance.
• Recognize workflow integration challenges within busy radiation oncology departments.

A full bladder is the preferred protocol and standard of care for patients receiving radiation treatment to the prostate or prostate bed. In daily practice, however, inadequate bladder filling is a frequent cause of treatment delays, repeat imaging and patient dissatisfaction. Radiation therapists are the first to identify these issues and must balance patient readiness with treatment accuracy and workflow efficiency. This session will highlight an ASRT-funded research project aimed at identifying variables that have an impact on bladder filling in patients undergoing prostate radiation therapy at a large academic medical center. Variables examined include age, treatment timing, nursing and dietitian consults, treatment site (prostate vs. prostate bed) and total number of treatments. The speakers will outline the research methods, results and potential clinical implications. Understanding which variables affect bladder filling can guide future practice, optimize protocols, improve workflow efficiency and reduce unnecessary imaging and patient wait times, ultimately enhancing patient satisfaction.

Patrycia Sek, M.P.H., R.T.(T)

Maria Dimopoulos, Ph.D., R.T.(T)

Objectives

• Recognize common clinical challenges contributing to bladder-related treatment interruptions.
• Identify patterns related to age, time of day and patient education that impact bladder preparation compliance.
• Summarize the variables in this study that influenced bladder filling in patients undergoing prostate and prostate bed radiation therapy.
• Apply insights from the study to enhance patient coaching, interdisciplinary communication and daily treatment workflow.

In the high-stakes environment of modern radiation oncology, radiation therapy professionals often focus on the how of technology while losing sight of the why of their practice. In this session, the speaker explores the riddle of why — the hidden psychological and professional drivers that dictate clinical choices. By examining the intersection of driven precision, the essential human element of compassion, and the necessity for professional growth, attendees will learn how to align their daily actions with the ever-evolving standards of patient-centered value.

Sean Ji-Won Kim, B.S., R.T.(R)(T), CMD

Objectives

• Compare workflows to bridge the gap between planning and delivery.
• Recognize compassion and connect technical excellence to the goal of "without fear of cancer."
• Explain how reducing the human maze of clinical complexity allows for more meaningful patient-provider connections.
• Identify growth through value partnerships — strategic, long-term collaborations that modernize technology while training the local workforce to handle evolving needs.

Mentorship in radiation therapy clinics is increasingly recognized as a critical component of workforce development, clinical safety and team cohesion. As departments navigate staffing shortages, increased patient complexity, burnout and multigenerational teams, strong mentorship programs provide a stabilizing structure that directly supports patient care quality and staff well-being. In this session, the speaker explores a two-way mentorship framework designed for modern radiation therapy environments, one in which both mentors and mentees actively contribute to learning, problem-solving and culture-building.

Current research across health care demonstrates that effective mentoring improves job satisfaction, increases retention, enhances communication and accelerates skill acquisition. Attendees will learn how to implement a practical, clinic-friendly mentorship pathway that includes pairing strategies, joint goal setting, check-ins, reflective feedback practices and simple outcome measurements. By fostering psychological safety, mutual respect and shared ownership of clinical excellence, radiation therapy departments can create inclusive, high-functioning learning environments that strengthen both patient outcomes and therapist satisfaction.

Heidi McGregor, A.S., R.T.(R)(T)(M)

Objectives

• Define mentorship in radiation oncology.
• Understand the benefits of mentorship in health care.
• Appreciate and leverage generational diversity in the radiation oncology clinic.
• Implement a structured mentoring program.
• Build inclusive, respectful mentoring relationships.

In this course, attendees will gain experiential knowledge of how radiation therapy is changing the world of veterinary medicine. Have you ever wondered about the treatment options for animals when they are diagnosed with cancer? What impact is radiation therapy having on the management of disease in large and even exotic animals? Attendees will increase their knowledge of veterinary medicine and better understand the power of this treatment modality in veterinary cancer.

Shivani Narayanan, B.S., R.T.(T)

Objectives

• Understand the history of radiation oncology.
• Understand the history of veterinary radiation oncology.
• Describe the differences between human and animal radiation therapy.
• Explore the future of veterinary radiation oncology.

In this course, the speakers will review workflow changes that can enhance health and wellness among radiation therapy staff through the use of proper body mechanics and the introduction of new tools designed to reduce physical strain in daily practice. The speakers will also identify common sources of physical strain within radiation therapy workflows and present practical, research-supported strategies for injury prevention. By improving ergonomic practices and safety measures, radiation therapists can enhance personal safety, optimize workflow efficiency and support the delivery of high-quality, consistent patient care.

Aileen Mariposa, B.S.R.T., R.T.(T)

Terrance T. Thomas, B.A., R.T.(T)

Objectives

• Identify common sources of physical strain and inefficiency within radiation therapy workflows.
• Understand the role of proper body mechanics in reducing workplace injury.
• Learn how new tools and workflow changes support staff health and wellness.
• Apply evidence-based ergonomic strategies during patient transfers and positioning.
• Discuss how implemented practices improve safety, efficiency and quality of patient care.

Health care is a highly collaborative, high-stakes environment where effective communication and leadership are essential for patient safety and team efficiency. This session introduces the 5 Voices framework as a practical tool for understanding five personality-based communication and leadership styles (Nurturer, Creative, Guardian, Connector and Pioneer). The session will include the speakers’ experience with integrating the 5 Voices framework into an educational environment and its impact on faculty and students. Through relatable, clinical-based scenarios, attendees will learn how these voices interact during real-world situations such as tumor board discussions and daily treatment workflows. By increasing self-awareness and appreciation of diverse perspectives, attendees will gain strategies to balance team dynamics and encourage inclusive dialogue in clinical and educational environments.

Amanda Hanstein, M.S.H.A., R.T.(T)

Marissa Mangrum, M.S.R.S., R.T.(T)

Objectives

• Describe the five communication styles and their strengths.
• Identify how the 5 Voices framework is integrated into an educational environment.
• Identify how each voice contributes to patient care and team function in radiation oncology.
• Recognize common communication challenges between different voices.
• Apply strategies to ensure all voices are heard and valued within multidisciplinary teams.

Radiation oncology safety initiatives are most effective when they improve not only safety but also clinical workflow. In this course, the speaker takes a frontline-centered approach to quality and safety improvement, highlighting how clinical workflow insight can meaningfully reduce risk and improve patient care. Through case-based examples, attendees will learn how risks are identified, how multidisciplinary buy-in is built, how resistance to change is navigated and how data and safety reporting are used to guide and sustain improvement.

The speaker will also explore the human side of safety events, including strategies to increase event reporting through de-shaming and reframing mistakes as opportunities for learning. The speaker will introduce the concept of the “third victim” of medical errors — the individual responsible for receiving, reviewing or responding to safety events — and approaches to supporting all parties involved. Attendees will leave with actionable tools to strengthen reporting cultures, translate errors into system-level change, and lead sustainable quality and safety initiatives in their own center.

Diana Ortega, B.S., R.T.(T), CPHQ

• Identify strategies for introducing quality and safety initiatives and fostering engagement.
• Compare successful implementation of process improvement innovations, including a new-start accuracy tool, improved timeout processes and other interventions that enhanced safety culture and reduced preventable harm.
• Define how to sustain quality improvements in real clinical environments, drawing from both wins and setbacks.
• Learn tips to confidently discuss safety events in ways that protect psychological safety and support everyone involved, including the “third victim.”
• Demonstrate quality and safety principles and data-driven decision-making in case-based examples.

*CE Disclaimers

 

Spatially fractionated radiation therapy or GRID radiation therapy using a brass block is a combination of an older grid-like therapy technique with the deep beam penetration available on modern linear accelerators. It offers treatment to patients with bulky or recurrent tumors when all other treatment options have failed.

Megan Krolo, B.S., R.T.(T)

Amanda Hetzel, B.S., R.T.(T)

• Define GRID therapy.
• Identify the treatment advantages of GRID therapy.
• Discuss the advantages and disadvantages of GRID therapy.
• Describe the specialty blocks used during GRID treatments.

Advanced practice radiation therapist roles have been implemented at select institutions across the United States over the past three years to address increasing clinical complexity, workforce pressures and the need for improved care coordination. An APRT is a radiation therapist who, through advanced education, training and mentorship, develops the knowledge, technical expertise and clinical judgment to practice at a higher level within the radiation oncologist-led team.

Although APRTs are expected to practice within a common four-pillar framework and at an elevated level of practice, the daily responsibilities of the role vary significantly between institutions based on local clinical needs and service gaps. At Mount Sinai Hospital in New York, the APRT was introduced into the inpatient palliative radiation therapy service as a novel care model to complement the rotating radiation oncologist coverage model, resulting in improved departmental efficiency, reduced resource waste and measurable time savings through task-shifting. At WashU Medicine in St. Louis, the APRT was embedded within the cone-beam computed tomography-guided adaptive radiation therapy program, leveraging advanced organs-at-risk contouring expertise to improve multidisciplinary workflow efficiency and allow physicians to focus on physician-specific responsibilities.

Clodagh Starrs, M.Sc., R.T.(T)

Robbie Beckert, B.S., R.T.(R)(T)

• Define the need for advanced practice radiation therapy within contemporary U.S. radiation oncology services.
• Explore international, evidence-based advanced practice radiation therapist practice frameworks and describe how they align with current palliative and adaptive radiation therapy models in the U.S.
• Summarize the daily clinical responsibilities of an APRT supporting inpatient palliative radiation therapy at Mount Sinai Hospital in New York. Give examples of case studies highlighting advanced decision-making in this role.
• Summarize the role of an APRT embedded within an adaptive radiation therapy service, including contouring and multidisciplinary workflow support, at WashU Medicine in St. Louis. Give examples of case studies highlighting advanced decision-making in this role.
• Identify potential pathways for establishing additional APRT roles currently being implemented across the U.S., including brachytherapy and solutions to rural treatment access.

Radiation therapists have powerful ideas, clinical insights and educational innovations, but many are unsure of how to translate them into publications or funded research. This interactive session is designed to help radiation therapists move from concept to concrete next steps. Through guided exercises, live refinement and facilitated discussion, attendees will actively workshop their own ideas. The speakers will begin the session with an overview of writing for ASRT journals and newsmagazines, including content alignment and submission best practices. Attendees will engage directly with members of the Radiation Therapist Editorial Review Board, gaining insight into the peer-review process, common pitfalls and what reviewers look for in successful submissions. Attendees will also be encouraged to brainstorm and refine a topic, identify gaps in the literature and shape a focused scholarly contribution.

The speakers will conclude the session with actionable strategies for transforming presentations and clinical experiences into publishable manuscripts, adopting an academic tone and exploring grant funding opportunities through the ASRT Foundation and the Research and Grants Advisory Panel. The goal is for attendees to leave not only inspired, but equipped, with a clear, individualized path toward publication and potential funding.

Maria Dimopoulos, Ph.D., R.T.(T)

Nora Uricchio, M.Ed., R.T.(R)(T)

Karen Kinman, B.S., ELS

• Recognize the professional value of scholarly writing and research engagement.
• Describe the submission and peer-review process for ASRT journals and newsmagazines.
• Develop a focused publication idea from a clinical experience, presentation or educational initiative.
• Identify potential ASRT Foundation funding opportunities and outline key components of a successful grant application.

As cancer treatments continue to increase patient survival and quality of life, treatments for several malignancies still wait for major success. Due to refinements in the understanding of the immune system and discrete cell identification, simple blood tests are set to offer even greater improvements in cancer detection and prevention.

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

Objectives

• Explain what a liquid biopsy is and how it is used.
• Identify the benefits and limitations of current liquid biopsy technology.
• Describe where liquid biopsies are of benefit to the patient in their cancer treatment journey.

Over the past two years, the American Society of Radiologic Technologists has convened the consensus work group to collaboratively define advanced practice radiation therapy with key national stakeholders and multidisciplinary representation across professional societies. This work was undertaken following the Consensus Committee on the Future of Medical Imaging and Radiation Therapy meeting, whose outcomes called for the establishment of new entryways and advancement opportunities for radiation therapists to ensure a resilient, adaptable workforce. Together, these efforts respond to ongoing workforce pressures, increasing clinical complexity and rapid technological advancement within radiation oncology, with the goal of establishing a clear, sustainable pathway for advanced practice in radiation therapy.

Building on earlier consensus discussions, the work group has progressed from conceptual exploration to evidence-informed action, with a focused examination of the current landscape of advanced practice radiation therapy within the United States. A multidisciplinary national survey was conducted to assess the current state of advanced practice radiation therapy, including definitions, perceived need, task distribution and professional boundaries. From there, the work group established a formal definition clarifying what advanced practice radiation therapy is and is not, explicitly defining professional guardrails.

As members of the consensus work group, the speakers of this session will present survey findings, including emerging alignment around core advanced practice functions and variability in implementation across practice settings. They will also summarize evidence-informed consensus outcomes while addressing some critical challenges, including reimbursement pathways and concerns regarding role expansion. Attendees will gain actionable insights into advanced practice radiation therapy development and shaping the future of the radiation therapy workforce.

Samantha Skubish, M.S., R.T.(R)(T)

Shaun T. Caldwell, Ed.D., R.T.(R)(T)

Objectives

• Describe the rationale for establishing advanced practice radiation therapy as a professional advancement pathway following the Consensus Committee on the Future of Medical Imaging and Radiation Therapy.
• Summarize multidisciplinary survey findings related to advanced practice radiation therapy definitions, perceived need and current implementation.
• Review the initiatives and outcomes of the consensus work group, including a white paper.
• Discuss role boundaries and professional guardrails and challenges to advanced practice radiation therapy implementation.
• Recognize opportunities for individual and organizational engagement in advanced practice radiation therapy implementation and workforce sustainability.

In this session, the speakers delve into innovative approaches to engage and educate contemporary students, highlighting their distinct learning preferences, technological aptitude and expectations. By acknowledging generational differences, educators can effectively connect with students through tailored learning strategies and the integration of technology in academic settings. Embracing the unique characteristics of today's students allows educators to cultivate more dynamic and engaging learning environments. The speakers of this session will provide radiation therapy educators with practical tools and insights to effectively connect with and inspire the future leaders of the profession.

Cheryl Young, Ed.D., R.T.(T)

Maureen Sigafoos, M.S., R.T.(T), CMD

Objectives

• Identify the demographics of the learner.
• Analyze the distinctive learning characteristics and technological preferences of Generation Z, identifying key differences from previous generations of learners.
• Evaluate current educational technologies and digital learning strategies that effectively engage and enhance student comprehension.
• Describe strategies for bridging generational communication gaps between experienced radiation therapy educators and contemporary students.
• Suggest adaptive teaching methodologies that simultaneously address technical skill development, critical thinking and emotional intelligence.

As clinical techniques and disease-site-specific planning become increasingly complex, successful patient outcomes depend on more than individual expertise — they require shared understanding and coordinated teamwork across disciplines. Variability in communication, handoffs and interpretation of clinical intent can create gaps between planning, delivery and outcomes.

In this session, the speakers introduce a practical model for closing the loop in clinical practice by integrating standardized communication frameworks with personalized clinical decision-making. Using disease-site-specific case studies and operational data, the speakers will demonstrate how shared ownership of patient outcomes enhances clarity, reduces rework and supports innovation without limiting clinical autonomy.

Christopher Gainer, B.S., R.T.(R)(T), CMD

Carrie Fritz, B.S., R.T.(R)(T)

Objectives

• Describe the impact of shared understanding and communication on technique- and disease-site-specific patient outcomes.
• Identify common breakdowns in multidisciplinary workflows and their clinical and operational consequences.
• Apply a practical model that balances standardization with personalized planning across clinical teams.
• Evaluate how shared ownership of patient outcomes supports quality, efficiency and innovation.

Osteoarthritis is a leading cause of pain and functional limitation across the world. Many patients experience persistent symptoms despite the use of conservative and interventional therapies. Low-dose radiation therapy has been used for decades in the treatment of osteoarthritis and other inflammatory conditions, yet it remains underutilized in the United States. This is due in part to radiophobia and the lack of familiarity with LDRT as a treatment option.

In this session, the speaker will review the historical role of radiation therapy in osteoarthritis, examine the biological mechanisms underlying its anti-inflammatory effects and critically assess the clinical evidence supporting its use. Practical considerations for implementing LDRT in clinical practice will be discussed, including patient selection, dose and fractionation schemes, treatment planning and technical delivery. The session will conclude with an overview of current research directions to bring attendees up to date with an understanding of LDRT for osteoarthritis.

Matt Spraker, Ph.D., M.D., DABR

Objectives

• Describe the historical use of low-dose radiation therapy for osteoarthritis and explain how radiophobia has influenced its adoption in modern clinical practice.
• Explain the proposed biological mechanisms and key clinical evidence supporting the use of LDRT for symptom management in osteoarthritis.
• Identify practical and technical considerations for implementing LDRT in the clinic, including patient selection, dose and fractionation, and treatment planning.
• List current research objectives and unanswered questions that may shape the future role of LDRT in the management of osteoarthritis.

Advanced practice radiation therapist roles are well established internationally and are emerging within the United States. Standardized and formalized educational pathways for APRT preparation in the U.S. are in development. In this session, the speaker presents the ASRT APRT educational framework and outlines the collaborative, evidence-informed process led by the ASRT to inform APRT education. The speaker will share findings from the literature, multidisciplinary U.S. stakeholder input, ASRT consensus activities, and international models that informed the guide, illustrating how these efforts collectively support a structured, scalable pathway for APRT education. The speaker will also introduce practical implementation resources — including an APRT infographic, a curated Zotero library of key references and an emerging skills acquisition framework — to support academic program development and clinical role integration.

Maria Dimopoulos, Ph.D., R.T.(T)

Objectives

• Identify current advanced practice preparation pathways in the U.S. and internationally.
• Describe the history and multidisciplinary collaboration supporting the development of the advanced practice radiation therapist educational framework.
• Explain U.S.-specific APRT research that supports educational framework development.

In this session, attendees will journey through a radiation therapist work transformation, gaining insights from more than 180 radiation therapist survey respondents. The speaker will share the takeaways of the work transformation journey: what created momentum, what caused friction and what could be done differently. Attendees will hear practical examples of how to clarify what matters most, reduce variation in daily work, improve handoffs and build team ownership through visible metrics and structured problem-solving. The speaker will also uncover common traps — overcustomization, unclear decision rights and change fatigue — as well as tactics that help sustain progress. Attendees will leave better equipped to lead change with their team — building ownership, reducing friction and sustaining progress over time.

Neil Hughes, M.B.A., R.T.(R)(T)(MR)(CT), MRSO

Objectives

• Define “transformation of work” in practical terms and distinguish it from isolated process improvement.
• Recognize four to six common signals that daily work needs redesign.
• Explain the leadership behaviors and structures that enable the adoption of a work transformation.
• Identify where resistance typically shows up and choose a response strategy.