Online Review

Zheng Chang, Ph.D.; Bridget Koontz M.D. Zheng Chang, Ph.D.; Bridget Koontz M.D.

Department of Radiation Oncology, Duke University Department of Radiation Oncology, Duke University Durham, North Carolina, 27710, United States Durham, North Carolina, 27710, United States

2011 IHE-RO Use Case: Online review

Online review now available for planar and Online review now available for planar and volumetric imaging, butvolumetric imaging, but

1.1. online approvalonline approval,,2. adaptive geometric matchmatch, and, and3.3. online dosimetric review online dosimetric review not available.not available.

Treatment now greatly reliant on Treatment now greatly reliant on timely therapy timely therapy deliverydelivery (1), (1), reliable and accurate positioning reliable and accurate positioning (2), and understanding of (2), and understanding of dose consequences of dose consequences of small positioning differencessmall positioning differences (3), for both SBRT (3), for both SBRT and standard fractionation therapy.and standard fractionation therapy.

“Online Review”Clinical Motivation / Need

2011 IHE-RO Use Case: Online review

Information Share: Information from RTP/Server to Online Review WS

Adaptive Dosimetric Assessment: Precursor of Adaptive Radiotherapy

Dosimetric Analysis: Accumulated and Individual Session

Online Administration: Online Approval

Adaptive Geometric Assessment: Deformable Registration

2011 IHE-RO Use Case: Online review

Reference Guidance: Reference Planar 2D/2D registration available for daily treatment guidance in addition to DRR. Reference can be set based on volumetric imaging

Desirable Features of“Online Review”

Hypo-fractioned Therapy Workflow

RTP WS

Geometric review with Deformable registrationInformation Share

2011 IHE-RO Use Case: Online review

Server

Online Review WS

Volumetric Imaging

Dosimetric ReviewDosimetric Analysis and Report

Online Approval

Pt ShiftTreatment

Fractionated Therapy Workflow

Patient positioned KV – DRR MatchCBCT – planCT Pt Shift

1ST FRACTION

2-nth FRACTION

* Option if KV-DRR match did not reproduce shift required for soft tissue match

2011 IHE-RO Use Case: Online review

Set 2D refKVTreatment

Patient positioned KV – refKV* Match Treatment

Online Approval Online Approval

Online Approval

Thank you!

2011 IHE-RO Use Case: Online review