Anh Hong Tu Le PhD, Presenter: Nothing to Disclose

Fion WK Cheung MS, Abstract Co-Author: Nothing to Disclose

The CAE system will represent a breakthrough in the routine IMRT planning workflow by eliminating all tedious manual evaluation steps and introducing remote plan evaluation across multiple locations by the local area network and Internet. The concept could also be adopted in the evaluation of plans other than IMRT.

IMRT has gained popularity in the treatment of cancers because of its excellent local control with decreased normal tissue complications. Yet, existing IMRT planning systems rely heavily on human inspection of resultant radiation dose distribution within the irradiated region of the body. Even for experienced planners, comparison of IMRT plans is definitely cumbersome and not error-free. Utilizing the DICOM-based electronic patient record (ePR) system with the computer-aided evaluation (CAE) system allows automatic evaluation of IMRT plans on the Web browser.

We have developed the system with DICOM-RT compliance that can store patient images and clinical data. The system was developed with current Web technology, Apache web server, PHP and and MySQL database and integrated with the CAE package. When the DICOM-RT objects are imported to the system, the key data items from the DICOM-RT objects will be extracted and available for the CAE to run the evaluation automatically. To eliminate the tedious manual evaluation, the direct relationships between the DVH data to the corresponding inhomogeneity regions on CT slices were found and displayed. Extraction of both overdose and underdose regions was based on the edge-based approach. Graphic User Interfaces (GUIs) were created to allow planners to establish customized plan acceptance criteria and query for evaluation results. Thirty IMRT plans were collected for technical verification and performance validation.

The system evaluation shows that it could be implemented in the clinical settings to benefit physicists and oncologists in treatment plan evaluation. The different between CAE output and those obtained manually by experienced planner shows no statistical difference. Also, the web-based infrastructure of the ePR with built-in CAE allows the evaluation to be done online to enhance to clinical workflow.

Le, A, Cheung, F, Automatic Treatment Plan Evaluation Utilizing a Web-based Electronic Patient Record (ePR) System and a Computer-aided Evaluation (CAE) for Intensity Modulated Radiation Therapy (IMRT) Plans.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11034216.html