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Development and Validation of a Comprehensive Remote Review Tool for Treatment Planning Quality Assurance for Multicenter Clinical Trials


Y Yan

Y Yan1*, R Timmerman1 , (1) UT Southwestern Medical Center, Dallas, TX

Presentations

SU-E-FS2-4 (Sunday, July 30, 2017) 1:00 PM - 1:55 PM Room: Four Seasons 2


Purpose: Multi-center clinical trials are increasingly being conducted outside the typical government-sponsored groups creating a challenge to appropriately review DICOM-RT plans from various Treatment Planning Systems (TPS). A dedicated, central plan review system to review for compliance would be useful for such trials. This study presents an independent plan review system we developed for the JOLT-Ca “Stablemates” phase III trial.

Methods: Radiotherapy centers enrolling to the trial could use various commercial TPSs and delivery systems including LINAC, CyberKnife and TomoTherapy units. Reviewing such plans on a commercial TPS is difficult due to incompatibilities. We developed an independent RT plan review system, DICOMan-TX, that accepts DICOM-RT exports from all TPSs. To assess protocol compliance, a dedicated protocol modeling module was implemented to translate protocol specific dose limits and constraints to a set of standard plan evaluation metrics which can be easily interpreted and evaluated. A comprehensive plan report in PDF format is automatically generated for purposes of documentation and audit.

Results: RT plans with complete sets of DICOM-RT objects were assessed in our plan review system for all enrolling sites using a variety of planning and treatment platforms. There-dimensional dose distributions, DVHs and target/organ dose statistics were rendered or tabulated. The plan compliance was scored using predefined protocol models. All plan assessment tools were validated against commercial TPSs. Good agreements with original plan reports were found. The minor discrepancies, such as segmented volumes of small structures, were noted. On average a plan could be thoroughly reviewed and documented in 5 minutes.

Conclusion: A dedicated plan review system was developed to re-construct and evaluate treatment plans generated by multiple institutions. Assessments showed that the resultant dose distributions were in agreement with the planning system from which they were generated making it a useful tool for remote review and quality assurance monitoring.


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