eContour Travel Award Application
Earn $500 travel award for the ACRO Annual Meeting.
First Name
*
Last Name
*
Email Address
*
Current training program or medical school
*
PGY
*
How did you learn about this award?
*
Disease Site/ Subsite
*
Stage of Disease (specifically TNM and group staging)
*
One line description of case history (must include age, gender, and pathology at minimum)
*
List the references of protocols/atlases/guidelines that contours are based on (at minimum 1)
*
Provide link(s) to peer-reviewed articles supporting your treatment paradigm (at minimum 1)
*
List the fused diagnostic images used, if applicable
*
Does your RT structure set reflect the nomenclature of The Report of AAPM Task Group 263?
*
Please specify treatment technique, dose/fractionation, and simulation specifications
*
Please specify details regarding target volumes (GTV, CTV, PTV) and OARS (as required)
*
Please specify any clinical pearls you wish to highlight (e.g. dose constraints or contouring advice with appropriate references)
*
Please tell us why your case adds value to the eContour website
*
Name of faculty reviewer/ mentor
*
Have contours been reviewed by the faculty reviewer/mentor?
*
Upload your CV Here
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Letter of support from Radiation Oncology faculty reviewer / mentor
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
I confirm that I will be available, at a minimum, by email, in late 2024 and 2025 for timely review of the submitted case with the eContour team as well as the case expert reviewer(s).
*
Enter the Application
Should be Empty: