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Program Information

Optimizing the Treatment Planning Process

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W Feng

J Chang

A Kapur

W Feng1*, J Chang2*, A Kapur3*, (1) (2) New York Weill Cornell Medical Ctr, New York, AA, (3) Long Island Jewish Medical Center, New Hyde Park, NY


MO-B-BRB-0 (Monday, July 13, 2015) 8:30 AM - 9:30 AM Room: Ballroom B

The radiotherapy treatment planning process has evolved over the years with innovations in treatment planning, treatment delivery and imaging systems. Treatment modality and simulation technologies are also rapidly improving and affecting the planning process. For example, Image-guided-radiation-therapy has been widely adopted for patient setup, leading to margin reduction and isocenter repositioning after simulation. Stereotactic Body radiation therapy (SBRT) and Radiosurgery (SRS) have gradually become the standard of care for many treatment sites, which demand a higher throughput for the treatment plans even if the number of treatments per day remains the same. Finally, simulation, planning and treatment are traditionally sequential events. However, with emerging adaptive radiotherapy, they are becoming more tightly intertwined, leading to iterative processes. Enhanced efficiency of planning is therefore becoming more critical and poses serious challenge to the treatment planning process; Lean Six Sigma approaches are being utilized increasingly to balance the competing needs for speed and quality.

In this symposium we will discuss the treatment planning process and illustrate effective techniques for managing workflow. Topics will include:

1. Planning techniques: (a) beam placement, (b) dose optimization, (c) plan evaluation (d) export to RVS.

2. Planning workflow: (a) import images, (b) Image fusion, (c) contouring, (d) plan approval (e) plan check (f) chart check, (g) sequential and iterative process

3. Influence of upstream and downstream operations: (a) simulation, (b) immobilization, (c) motion management, (d) QA, (e) IGRT, (f) Treatment delivery, (g) SBRT/SRS (h) adaptive planning

4. Reduction of delay between planning steps with Lean systems due to (a) communication, (b) limited resource, (b) contour, (c) plan approval, (d) treatment.

5. Optimizing planning processes: (a) contour validation (b) consistent planning protocol, (c) protocol/template sharing, (d) semi-automatic plan evaluation, (e) quality checklist for error prevention, (f) iterative process, (g) balance of speed and quality

Learning Objectives:
1. Gain familiarity with the workflow of modern treatment planning process.
2. Understand the scope and challenges of managing modern treatment planning processes.
3. Gain familiarity with Lean Six Sigma approaches and their implementation in the treatment planning workflow.

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