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Radiation Oncology v1 Slide # 1 DICOM Conference - Singapore April 1, 2005 Radiation Oncology v1 Slide # 1 DICOM Conference - Singapore April 1, 2005 Dwight.

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Presentation on theme: "Radiation Oncology v1 Slide # 1 DICOM Conference - Singapore April 1, 2005 Radiation Oncology v1 Slide # 1 DICOM Conference - Singapore April 1, 2005 Dwight."— Presentation transcript:

1 Radiation Oncology v1 Slide # 1 DICOM Conference - Singapore April 1, 2005 Radiation Oncology v1 Slide # 1 DICOM Conference - Singapore April 1, 2005 Dwight A. Simon, Medical Standards Director and Senior Integration Specialist Merge eFilm * * * Co-Chair DICOM Standards Committee 2005 DICOM Conference Radiation Therapy in Oncology in Singapore

2 Radiation Oncology v1 Slide # 2 DICOM Conference - Singapore April 1, 2005 Acknowledgement This presentation is given on behalf of DICOM WG7: Radiation Therapy It has been prepared in conjunction with material from: - Dr. Michael Neumann, Institute of Clinical Biochemistry and Pathobiochemistry - Scot Hogan, Chair - WG7 Ion Subcommittee - David Murray, Chair – DICOM WG7 Vital Edge Limited TomoTherapy, Incorporated

3 Radiation Oncology v1 Slide # 3 DICOM Conference - Singapore April 1, 2005 Radiation Therapy in DICOM What it isn’t – acquisition information for diagnosing a patients condition (CT, MR, Ultrasound, Mammography, Digital X-Ray, etc.) What it is – a description of how to treat a patient (a Plan of treatment, the Doses of radiation to apply, in what manner and in what quantity, plus the ability to simulate the treatment, etc.)

4 Radiation Oncology v1 Slide # 4 DICOM Conference - Singapore April 1, 2005 Radiation Therapy Objects (SOP Classes) (non-RT – CT, MR, PET & Fused Images) RT Image RT Dose RT Structure Set RT Plan RT Beams Treatment RT Brachy Treatment RT Treatment Summary

5 Radiation Oncology v1 Slide # 5 DICOM Conference - Singapore April 1, 2005 Use of General Purpose Worklist in Radiation Therapy A need to manage the various “ phases ” of radiation therapy, such as transition from: simulation to planning to delivery to adaptive therapy A need to schedule these services Also a need for new functionality: for referencing persistent objects like RT Plans, CT Images and new objects like Dose Calculation for having ability to Notify performing application, rather than depending on application to continually check for something new or changed

6 Radiation Oncology v1 Slide # 6 DICOM Conference - Singapore April 1, 2005 General Purpose Worklist

7 Radiation Oncology v1 Slide # 7 DICOM Conference - Singapore April 1, 2005 General Purpose Worklist (RT) Controlling Device Archive Workflow Manager Performing Application Store SOP Instances Receive GP-SPS Update GP-SPS (IN PROGRESS) Create GP-PPS (IN PROGRESS) Set GP-PPS (COMPLETED) Update GP-SPS (COMPLETED) Store Results Cancel GP-SPS (N-SET) Initiate creation of GPSPS (N-CREATE) Query GP-SPS Notify GP-SPS (N-EVENT-REPORT) Get Progress (N-GET) Instances for Input Transmit SOP and Relevant Information Notify Progress (N-EVENT-REPORT)

8 Radiation Oncology v1 Slide # 8 DICOM Conference - Singapore April 1, 2005 Scenarios Controlling Device requests... Segmentation Treatment planning Dose calculation Treatment plan evaluation Treatment Port film

9 Radiation Oncology v1 Slide # 9 DICOM Conference - Singapore April 1, 2005 Scenarios – Referenced Objects IM – Image (CT, MR, …) SS – RT Structure Set RI – RT Image RD – RT Dose RP – RT Plan BM – RT Beams Treatment Record BR – RT Brachy Treatment Record SU – RT Treatment Summary Record

10 Radiation Oncology v1 Slide # 10 DICOM Conference - Singapore April 1, 2005 Scenarios – Object References IMSSRIRDRPBMBRSU Segmentation XX Treatment Planning XXXX Dose Calculation XXXX Plan Evaluation XXXXX Treatment XXXXX Port film XXXX

11 Radiation Oncology v1 Slide # 11 DICOM Conference - Singapore April 1, 2005 Scenarios – Segmentation YN Request Segmentation SS exists CT C-STORE Create SS CT, SS Create SS ‘

12 Radiation Oncology v1 Slide # 12 DICOM Conference - Singapore April 1, 2005 Scenarios – Segmentation New segmentation Existing segmentation Continue segmentation Modify segmentation Parameters List of organs List of colors Margins

13 Radiation Oncology v1 Slide # 13 DICOM Conference - Singapore April 1, 2005 Scenarios – Treatment Planning Request Treatm. Plang. Plan exists CT, SS, PRE CT, SS, RI, PRE, RTP C-STORE Create RTP, RI New Version CT, SS, PRE, RTP Create RTP 2, RI Create RTP ‘, RI YN YN PRE – RT Prescription IOD* * not defined yet

14 Radiation Oncology v1 Slide # 14 DICOM Conference - Singapore April 1, 2005 Scenarios – Treatment Planning New treatment plan Existing treatment plan New version Competing plan Parameters Technique Number of beams Treatment unit

15 Radiation Oncology v1 Slide # 15 DICOM Conference - Singapore April 1, 2005 Scenarios – Dose Calculation Request Dose Calc. Dose exists CT, SS, CAL, RTP C-STORE Create DOS CT, SS, DOS CAL, RTP Create DOS ‘ YN CAL – RT Calculation IOD* * not defined yet

16 Radiation Oncology v1 Slide # 16 DICOM Conference - Singapore April 1, 2005 Scenarios – Dose Calculation New dose calculation Existing dose calculation Correct for treatment errors Accumulate previous dose Parameters Algorithm Dose grid Inhomogeneity correction Physical constraints Biological constraints

17 Radiation Oncology v1 Slide # 17 DICOM Conference - Singapore April 1, 2005 Scenarios – Plan Evalutation Request Plan Eval. CT, RI, SS, DOS, RTP C-STORE Create RTP ‘

18 Radiation Oncology v1 Slide # 18 DICOM Conference - Singapore April 1, 2005 Scenarios – Plan Evalutation Approve treatment plan Parameters

19 Radiation Oncology v1 Slide # 19 DICOM Conference - Singapore April 1, 2005 Scenarios – Treatment Request Treatment Interrupt before RTP, RI, BM, BR, SU RTP, RI, BM, BR, SU C-STORE Create BM, BR, SU Comp. RTP, RI, BM, BR, SU Create BM, BR, SU Create BM, BR, SU YN YN

20 Radiation Oncology v1 Slide # 20 DICOM Conference - Singapore April 1, 2005 Scenarios – Treatment Normal treatment Treatment interrupt before Compensate Patient setup correction Parameters

21 Radiation Oncology v1 Slide # 21 DICOM Conference - Singapore April 1, 2005 Scenarios – Port Film Request Port Film RTP, RI, BM, BR C-STORE Create RI

22 Radiation Oncology v1 Slide # 22 DICOM Conference - Singapore April 1, 2005 Scenarios – Port Film Take port film Parameters Beam related With dose accumulation Before / after treatment Single / double exposure

23 Radiation Oncology v1 Slide # 23 DICOM Conference - Singapore April 1, 2005 Required Parameters Segmentation List of organs List of colors Margins Treatment planning Technique Number of beams Treatment unit Dose calculation Algorithm Dose grid Inhomogeneity correction Physical constraints Biological constraints Port film Beam related With dose accumulation Before / after treatment Single / double exposure

24 Radiation Oncology v1 Slide # 24 DICOM Conference - Singapore April 1, 2005 Ion Therapy Manufacturers of Ion Therapy equipment are now actively involved in implementation of Ion Therapy systems, even though all the work on this new DICOM function is not finalized

25 Radiation Oncology v1 Slide # 25 DICOM Conference - Singapore April 1, 2005 Two New IODs Created RT Ion Plan contains pretreatment definition RT Ion Treatment Record contains post treatment records New IODs created because: Existing RT Plan has type 1 and 2 (Required) attributes that are not applicable to Ion Therapy New type 1 and 2 attributes are introduced for Ion Therapy for interoperability

26 Radiation Oncology v1 Slide # 26 DICOM Conference - Singapore April 1, 2005 Beam Line Modifiers All Ion Therapy beam line modifiers have been categorized into: Range Shifting Devices Lateral Spreading Devices Range Modulation Devices Snout Some machines have interchangeable Snouts

27 Radiation Oncology v1 Slide # 27 DICOM Conference - Singapore April 1, 2005 Traditional Accessories Range Compensators Bolus Apertures

28 Radiation Oncology v1 Slide # 28 DICOM Conference - Singapore April 1, 2005 Other Differences No Source-to-Axis distance All measurements taken from isocenter X/Y dependant Virtual SAD added for device manufacturing 6 Degrees of freedom couch Pitch and Roll angles defined All imaging performed by x-ray sources Passive and Scanning beams

29 Radiation Oncology v1 Slide # 29 DICOM Conference - Singapore April 1, 2005 Status of On-Going Work Has undergone final review by WG7 Ion Subcommittee and is out for vote. Subcommittee has T-CON at least once a month. Two meetings held in conjunction with PT-COG. Several implementations are undergoing testing – they go live January 2006.

30 Radiation Oncology v1 Slide # 30 DICOM Conference - Singapore April 1, 2005 IHE in Radiation Oncology (IHE-RO) A stage 1 demonstration scenario was developed: involves a “normal flow” use case for a patient in a radiotherapy department can be achieved using existing DICOM components extended set of query/retrieve attributes specific to radiation therapy is being defined to enhance interoperability between radiation therapy systems enhanced General Purpose Worklist for RT may also be used in the demonstrations. A number of extensions and “non-normal flows” have been identified for implementation in future years.

31 Radiation Oncology v1 Slide # 31 DICOM Conference - Singapore April 1, 2005 Thank You!


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