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1September, 2005 What IHE Delivers
IHE-ROIHE-RORadiation OncologyRadiation Oncology
IHE Workshop 2006IHE Workshop 2006Scott Johnson, Keith La PlainScott Johnson, Keith La Plain
2
AgendaAgenda
SponsorsSponsors
RO TeamRO Team
Road MapRoad Map
ActorsActors
Connectathon 2006Connectathon 2006
Connectathon 2007Connectathon 2007
Future DirectionFuture Direction
3
Primary Membership SponsorsPrimary Membership Sponsors
Radiation Oncology VendorsRadiation Oncology Vendors Delivery Devices – Linacs, Cobalt, BrachytherapyDelivery Devices – Linacs, Cobalt, Brachytherapy SimulatorsSimulators Treatment Planning SystemsTreatment Planning Systems Oncology Information Systems Oncology Information Systems
Physician Associations & CollegesPhysician Associations & Colleges ASTROASTRO AAPM (American Association of Physicists in Medicine)AAPM (American Association of Physicists in Medicine) ATC (Advanced Technology Consortium)ATC (Advanced Technology Consortium)
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RO Team – Who’s WhoRO Team – Who’s Who
Planning CommitteePlanning Committee
Keith La Plain (Varian)Keith La Plain (Varian)
Jay Cooper, MDJay Cooper, MD
Prabhakar Tripuraneni, MD Prabhakar Tripuraneni, MD (ASTRO)(ASTRO)
Jatinder Palta, PhD Jatinder Palta, PhD (U Florida)(U Florida)
Technical CommitteeTechnical Committee
Bruce Curran (U Mich)Bruce Curran (U Mich)
Stuart Swerdloff (Impac)Stuart Swerdloff (Impac)
Dave Murray (Tomotherapy)Dave Murray (Tomotherapy)
Bill Bennett (CMS)Bill Bennett (CMS)
Ulrich Busch (Varian)Ulrich Busch (Varian)
Jaap Pijpelink (Nucletron)Jaap Pijpelink (Nucletron)
Brian Frederiksen (Siemens)Brian Frederiksen (Siemens)
Colin Winfield (Elekta)Colin Winfield (Elekta)
Scott Johnson (Philips)Scott Johnson (Philips)
Jeff Szuhay (NOMOS/NAS)Jeff Szuhay (NOMOS/NAS)
Walter Bosch (Wash U ATC)Walter Bosch (Wash U ATC)
Stephen Vastagh (NEMA)Stephen Vastagh (NEMA)
Alan Gay (ASTRO)Alan Gay (ASTRO)
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Profile RoadmapProfile Roadmap
Year 2005-2006 (Initial Implementation)Year 2005-2006 (Initial Implementation) Image Set Contouring Image Set Contouring Storage & RetrievalStorage & Retrieval
• Structure SetStructure Set• Geometric PlanGeometric Plan• Dosimetric PlanDosimetric Plan• Dose Dose
Multi Series Image ReviewMulti Series Image Review Combined CT StorageCombined CT Storage
Year 2006-2007Year 2006-2007 RT Plan – enlarging scope of objects : wedges, arcsRT Plan – enlarging scope of objects : wedges, arcs Scheduling of Treatment Delivery - GPWLScheduling of Treatment Delivery - GPWL Fusion (Multi-modality)Fusion (Multi-modality) Query / RetrieveQuery / Retrieve
FutureFuture Further RT Plan enlargementFurther RT Plan enlargement 4D Support for gating, breath-hold, adaptive therapy4D Support for gating, breath-hold, adaptive therapy
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Domain Visibility & SupportDomain Visibility & Support
ASTRO Annual ConferenceASTRO Annual Conference 2006 ASTRO : Inaugural IHE-RO Showcase 2006 ASTRO : Inaugural IHE-RO Showcase
Other Potential ConferencesOther Potential Conferences AAPMAAPM HIMSSHIMSS RSNARSNA
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ActorsActors
ArchiveArchive
ContourerContourer
Geometric PlannerGeometric Planner
Dosimetric PlannerDosimetric Planner
Dose DisplayerDose Displayer
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Connectathon 2006Connectathon 2006
TimingTiming Week of September 25Week of September 25thth, 2006, 2006
LocationLocation “undetermined”“undetermined”
Use CasesUse Cases Single Contoured/Image Series RetrievalSingle Contoured/Image Series Retrieval Structure Set StorageStructure Set Storage Geometric Plan StorageGeometric Plan Storage Dosimetric Plan StorageDosimetric Plan Storage Dose StorageDose Storage Multi Series Image ReviewMulti Series Image Review Structure Set RetrievalStructure Set Retrieval Geometric Plan RetrievalGeometric Plan Retrieval Dosimetric Plan RetrievalDosimetric Plan Retrieval Dose RetrieveDose Retrieve Combined CT StorageCombined CT Storage
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Single Contoured/Image Series RetrievalSingle Contoured/Image Series Retrieval
Description:Description: In the Single/Contoured Image Series In the Single/Contoured Image Series Retrieve transaction, the Archive sends a series of Retrieve transaction, the Archive sends a series of CT-Images to the CT-Images to the ContourerContourer, , Geometric PlannerGeometric Planner, or , or Dosimetric PlannerDosimetric Planner..
Actor:Actor:ArchiveArchive
Role:Role: Transmit CT Series to Transmit CT Series to ContourerContourer, , Geometric Geometric PlannerPlanner, or , or Dosimetric PlannerDosimetric Planner
Actor:Actor:ContourerContourer, , Geometric PlannerGeometric Planner, or , or Dosimetric Dosimetric PlannerPlanner
Role:Role: Receives and stores CT Series from ArchiveReceives and stores CT Series from Archive
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Structure Set StorageStructure Set Storage
Description:Description: In the Structure Set Storage Transaction, In the Structure Set Storage Transaction, the the ContourerContourer stores a Structure Set on an Archive to stores a Structure Set on an Archive to make it available. make it available.
Actor:Actor:ContourerContourer
Role:Role: Sends Structure Set to ArchiveSends Structure Set to Archive
Actor:Actor:ArchiveArchive
Role:Role: Stores Structure Set received from Stores Structure Set received from ContourerContourer
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Geometric Plan StorageGeometric Plan Storage
Description:Description: In the In the Geometric Plan Geometric Plan Storage Storage transaction, the transaction, the Geometric PlannerGeometric Planner sends the sends the newly created newly created Geometric Plan Geometric Plan to the Archive.to the Archive.
Actor:Actor:Geometric PlannerGeometric Planner
Role:Role: Transmit generated Transmit generated Geometric Plan Geometric Plan to the to the ArchiveArchive
Actor:Actor:ArchiveArchive
Role:Role: Receives and stores Geometric Plans from Receives and stores Geometric Plans from the the Geometric PlannerGeometric Planner
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Dosimetric Plan StorageDosimetric Plan Storage
Description:Description: In this transaction, the In this transaction, the Dosimetric Dosimetric PlannerPlanner sends the plan containing the references sends the plan containing the references to the structure set to the Image Archive.to the structure set to the Image Archive.
Actor:Actor:Dosimetric PlannerDosimetric Planner
Role:Role: Transmit generated plan to Image Archive.Transmit generated plan to Image Archive.
Actor:Actor:ArchiveArchive
Role:Role: Accept and store plan from Accept and store plan from Dosimetric Dosimetric PlannerPlanner..
13
Dose StorageDose Storage
Description:Description: In the Dose Storage transaction, the In the Dose Storage transaction, the Dose planner sends the newly created Dose to Dose planner sends the newly created Dose to the Archive.the Archive.
Actor:Actor:Dosimetric PlannerDosimetric Planner
Role:Role: Transmit generated Dose to the ArchiveTransmit generated Dose to the Archive
Actor:Actor:ArchiveArchive
Role:Role: Receives and stores Doses from the Receives and stores Doses from the Dosimetric PlannerDosimetric Planner
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Multi Series Image ReviewMulti Series Image Review
Description:Description: In the Multi-Series Image Retrieve In the Multi-Series Image Retrieve Transaction, the Archive stores CT Images from Transaction, the Archive stores CT Images from multiple series (but a single study) on a multiple series (but a single study) on a ContourerContourer to to make these Images available for contouring.make these Images available for contouring.
Actor:Actor:ArchiveArchive
Role:Role: Sends CT Images to the Sends CT Images to the ContourerContourer
Actor:Actor:ContourerContourer
Role:Role: Stores CT Images received from ArchiveStores CT Images received from Archive
15
Structure Set RetrievalStructure Set Retrieval
Description:Description: In the Structure Set Retrieval Transaction, In the Structure Set Retrieval Transaction, the Archiver stores a Structure Set on a the Archiver stores a Structure Set on a ContourerContourer, , Geometric PlannerGeometric Planner, , Dosimetric PlannerDosimetric Planner, or Dose Displayer. , or Dose Displayer.
Actor:Actor:ArchiveArchive
Role:Role: Sends Structure Set to Sends Structure Set to ContourerContourer, , Geometric Geometric PlannerPlanner, , Dosimetric PlannerDosimetric Planner, or Dose Displayer, or Dose Displayer
Actor:Actor:ContourerContourer, , Geometric PlannerGeometric Planner, , Dosimetric PlannerDosimetric Planner, , or or Dose DisplayerDose Displayer
Role:Role: Stores Structure Set received from ArchiveStores Structure Set received from Archive
16
Geometric Plan RetrievalGeometric Plan Retrieval
Description:Description: In the In the Geometric Plan Geometric Plan Retrieve Retrieve Transaction, the requested Transaction, the requested Geometric Plan Geometric Plan is is transferred from the Archive to the transferred from the Archive to the Dosimetric Dosimetric PlannerPlanner..
Actor:Actor:Dosimetric PlannerDosimetric Planner
Role:Role: Receives requested Receives requested Geometric Plan Geometric Plan from the from the ArchiveArchive
Actor:Actor:ArchiveArchive
Role:Role: Sends requested Sends requested Geometric Plan Geometric Plan instance to instance to the the Dosimetric PlannerDosimetric Planner
17
Dosimetric Plan RetrievalDosimetric Plan Retrieval
Description:Description: In this transaction, the dose In this transaction, the dose displayer retrieves the plan containing the displayer retrieves the plan containing the references to the structure set to the Image references to the structure set to the Image Archive.Archive.
Actor:Actor:Dose DisplayerDose Displayer
Role:Role: Accepts plan from Archive.Accepts plan from Archive.
Actor:Actor:ArchiveArchive
Role:Role: Transmits plan to Transmits plan to Dose ViewerDose Viewer..
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Dose RetrieveDose Retrieve
Description:Description: In the Dose Retrieve Transaction, the In the Dose Retrieve Transaction, the requested Dose is transferred from the Archive to requested Dose is transferred from the Archive to the Dose Displayer.the Dose Displayer.
Actor:Actor:Dose DisplayerDose Displayer
Role:Role: Receives requested Dose from the ArchiveReceives requested Dose from the Archive
Actor:Actor:ArchiveArchive
Role:Role: Sends requested Dose instance to the Sends requested Dose instance to the Dose DisplayerDose Displayer
19
Combined CT StorageCombined CT Storage
Description:Description: In the Resampled/Combined CT In the Resampled/Combined CT Series Storage Transaction, the Series Storage Transaction, the ContourerContourer stores stores CT Images which have been combined or CT Images which have been combined or resampled into a single series on the Archive.resampled into a single series on the Archive.
Actor:Actor:ContourerContourer
Role:Role: Sends CT Images to the ArchiveSends CT Images to the Archive
Actor:Actor:ArchiveArchive
Role:Role: Stores CT Images received from Stores CT Images received from ContourerContourer
20
Connectathon 2007Connectathon 2007
Worklist / Scheduling & GP WorklistWorklist / Scheduling & GP Worklist
Query/Retrieve Extensions to support RT Query/Retrieve Extensions to support RT ObjectsObjects
Complete External Beam Definition of RT Complete External Beam Definition of RT PlanPlan
Multi-Modality Registration/FusionMulti-Modality Registration/Fusion
21
GP WorklistGP Worklist
Treatment Delivery includingTreatment Delivery including
Selecting a Treatment from the Oncology Information Selecting a Treatment from the Oncology Information System (OIS)System (OIS)
Sending Treatment to Treatment Delivery System Sending Treatment to Treatment Delivery System
Setup & Position Verification including Imaging and Other Setup & Position Verification including Imaging and Other DevicesDevices
Image Acquisition Including CTImage Acquisition Including CT
Delivering TreatmentDelivering Treatment
Saving Treatment RecordSaving Treatment Record
Updating the OISUpdating the OIS
IODs Documented in DICOM Draft Supplement 74 : IODs Documented in DICOM Draft Supplement 74 :
Utilization of Worklist in Radiotherapy Treatment DeliveryUtilization of Worklist in Radiotherapy Treatment Delivery
22
Query/Retrieve ProfilesQuery/Retrieve Profiles
Support Query/Retrieval of RT Objects Support Query/Retrieval of RT Objects from PACS, et alfrom PACS, et al
RT Objects have richer set of references RT Objects have richer set of references than radiology objectsthan radiology objects
Required query elements include Required query elements include referenced objectsreferenced objects
Modalities themselves (Planners, Modalities themselves (Planners, Contourers) may also support Q/R of RT Contourers) may also support Q/R of RT ObjectsObjects
23
RT Plan ProfilesRT Plan Profiles
Profiles will be specified in terms of beam Profiles will be specified in terms of beam delivery types.delivery types.
Each beam type supports a subset of Each beam type supports a subset of modifiers.modifiers.
Conformance will be specified with Conformance will be specified with respect to the beam type profile and respect to the beam type profile and supported modifiers.supported modifiers.
24
RT Plan ConformanceRT Plan Conformance
Jaws MLC Bolus Block Compensator Static Wedge
Electron Cone
Electron Trimmer
Stereo Collimator
Static Motorized
Wedge
Virtual Wedge
Arc Conformal
Arc
Step and Shoot
Sliding Window
Electron
Stereotactic
Beam ModifiersBeam Modifiers
Bea
m
Bea
m
Pro
files
Pro
files
25
Registration/FusionRegistration/Fusion
Affine, Deformable, Global, LocalAffine, Deformable, Global, Local
CT, MR, PET, US, SPECTCT, MR, PET, US, SPECT
Multiple (~30) Volume DatasetsMultiple (~30) Volume Datasets
CBCT SupportCBCT Support
Contour redefinition vs Contour PastingContour redefinition vs Contour Pasting
26
Future DirectionFuture Direction
Brachytherapy (LDR & HDR)Brachytherapy (LDR & HDR)
Clinical Trials SubmissionsClinical Trials Submissions
4D : gating, breath hold, adaptive, fluoroscopic monitoring4D : gating, breath hold, adaptive, fluoroscopic monitoring
Plan transfer to treatment delivery devicePlan transfer to treatment delivery device
Enhanced dose exchangeEnhanced dose exchange
Enhanced worklist : Dose Calculation Scheduling, Planning Enhanced worklist : Dose Calculation Scheduling, Planning Scheduling (Simulation, Contouring, Planning)Scheduling (Simulation, Contouring, Planning)
Multiple-independent delivery devices – Micro MLCsMultiple-independent delivery devices – Micro MLCs
ION SupportION Support