1. IHE-RO Future Profiles Bruce Curran Assistant Professor / University of Michigan

2. Proposed Use Cases 2007 … Compositing Dose Residual Dose Optimization Image Fusion (Selected for 2008) On-line Image Review (reference image vs. delivery image) Off-line Image Review (reference image vs. delivery image) Scheduling Treatment Delivery and Verify/Record (Selected for 2008) Query/Retrieve Clinical Trials Augmentation of RT Objects Profile to encompass additional treatment modalities

3. Compositing Dose Summing multiple dose distributions defined in a common frame of reference (derived from same image series); optionally stores summed dose in archive.

4. Residual Dose Optimization (“Dosimetric planner with prior dose”) – retrieves (planned or delivered?) dose distribution, CT image, RTSS, and Prescription (out of band).

5. On-line Image Review 2D-2D – retrieve patient setup DRRs, RT Plan from archive; acquire setup image(s); compare and display correction transformation 3D-2D – retrieve planning CT, RTSS, RT Plan (and RT Dose) from archive; acquire verification CT; compare and display correction transformation 3D-3D – retrieve planning CT, RTSS, RT Plan (and RT Dose) from archive; acquire verification CT; compare and display correction transformation

6. Off-line Image Review 2D-2D – [Delivery Imaging System] acquire and store setup images and Spatial Registration in archive; [Offline Review System] retrieve patient setup DRRs, setup images, Spatial Registration, RT Plan from archive; compare, display, and store correction transformation in archive 3D-2D – [Delivery Imaging System] acquire and store verification CT and Spatial Registration in archive; [Offline Review System] retrieve planning CT, verification CT(s), Spatial Registration, RTSS, RT Plan, (and RT Dose) from archive; compare, display, and store correction transformation in archive 3D-3D – [Delivery Imaging System] acquire and store verification CT and Spatial Registration in archive; [Offline Review System] retrieve planning CT, verification CT(s), Spatial Registration, RTSS, RT Plan, (and RT Dose) from archive; compare, display, and store correction transformation in archive

7. Query/Retrieve –Series level Q/R from archive Generally supported by PACS systems For PACS users, there is often an HTTP interface. For RT CT systems, generally it is a problem needing to be solved. Users would like to be able to get CT and RT objects from one source. –RT (Instance-level) objects from archive Often not supported by institution-wide PACS systems