Software for automated quality assurance for radiotherapy patient treatment plans

A.Xing1, S. Arumugam1, L.Holloway1-4, P. Vial1, 2 ,, G.Goozee1,4

1Liverpool and Macarthur cancer therapy centres and Ingham Institute, Liverpool Hospital, NSW, Sydney, Australia.2Institute of Medical Physics, School of Physics, University of Sydney, Sydney, NSW, Australia. 3Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW, Australia. 4South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia

• Modern radiation treatment techniques are complex

• Comprehensive plan checking is required

• Manual checking of individual plan parameters is time consuming and potentially error prone

Background

PlanChecking in our existing workflow

Physicist planning Consult

(RT & Physicists before approval)

RT print plan chart

(RT after RO approve plan)

Physics & RT plan checking

(after transfer to R&V system)

• Local and international incidence databases indicate a relatively high number of incidences are seen during planning and data transfer

Background

RADIOTHERAPY RISK PROFILE Technical Manual published by WHO

Aim of the project

To develop a software tool, PlanChecker, for more efficient and more comprehensive checking of:

• 3DCRT

• IMRT

• VMAT

Radiotherapy plans

Functionality goals for PlanChecker

• Easily fits into the current workflow.• Checks the integrity and consistency of transferring plan data

from TPS to R&V system• Checks the contours e.g.: Name convention, consistency etc• Checks the plan quality e.g.: plan objectives and quality

metrics.• Full automation • Running either as server and or as a standalone program on

any PCs or centralized computers.• General enough to run the system at different centres with

different platforms, TPS and delivery systems.

PlanChecker in existing workflow

RT export RTP file

TPS(XiO, Pinnacle, Tomo)

MOSAIQ

Network Directory

RT import RTP file

RT export:RTP fileDICOM dose file DICOM plan fileDICOM structure file

PlanChecker

Generate a pdf Report

Physics/RT run PlanChecker.

PlanChecker use-GUI interface

PlanChecker functionality -

patient identityComprehensive checking by PlanChecker:-Patient Identity

Comprehensive checking by PlanChecker:-Treatment Prescription

PlanChecker functionality-

Treatment prescription

Comprehensive checking by PlanChecker:-Patient setup

PlanChecker functionality-

Patient Set-up

Comprehensive checking by PlanChecker:-complete beam parameters for each beam

PlanChecker functionality-

Beam parameters

Comprehensive checking by PlanChecker:-All control point parameters for each beam

PlanChecker functionality-

beam control points

PlanChecker output -Summarized results

Validation of PlanChecker-error simulation testing

PlanChecker

Errors introduced in MOSAIQ

Validation of PlanChecker-error simulation results

• 126 plans with simulated errors demonstrated accurate error detection.

• Use of Planchecker and manual process completed side by side with over 50 clinical plans

• All plans successfully checked

Validation of PlanChecker-within a clinical setting

Future Work-Functionality goals for PlanChecker

• Easily fits into the current workflow.• Checks the integrity and consistency of transferring plan data

from TPS to R&V system• Checks the contours e.g.: Name convention, consistency etc• Checks the plan quality e.g.: plan objectives and quality

metrics.• Full automation • Running either as server and or as a standalone program on

any PCs or centralized computers.• General enough to run the system at different centres with

different platforms, TPS and delivery systems.

Conclusions

• A software system, PlanChecker was developed and prototyped for comprehensive checking of simple and complicated radiotherapy plans.

• Error simulation testing validated use of PlanChecker• The system is still being actively developed to include

more modules for comprehensive plan checking.