September, 2005What IHE Delivers 1 IHE-RO Radiation Oncology IHE Workshop 2006 Scott Johnson, Keith La Plain

1September, 2005 What IHE Delivers

IHE-ROIHE-RORadiation OncologyRadiation Oncology

IHE Workshop 2006IHE Workshop 2006Scott Johnson, Keith La PlainScott Johnson, Keith La Plain

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AgendaAgenda

SponsorsSponsors

RO TeamRO Team

Road MapRoad Map

ActorsActors

Connectathon 2006Connectathon 2006


Future DirectionFuture Direction

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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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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


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


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.


Role:Role: Accept and store plan from Accept and store plan from Dosimetric Dosimetric PlannerPlanner..

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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.


Role:Role: Transmit generated Dose to the ArchiveTransmit generated Dose to the Archive


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.


Role:Role: Sends CT Images to the Sends CT Images to the ContourerContourer


Role:Role: Stores CT Images received from ArchiveStores CT Images received from Archive

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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.


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

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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..


Role:Role: Receives requested Receives requested Geometric Plan Geometric Plan from the from the ArchiveArchive


Role:Role: Sends requested Sends requested Geometric Plan Geometric Plan instance to instance to the the Dosimetric PlannerDosimetric Planner

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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.


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


Role:Role: Sends requested Dose instance to the Sends requested Dose instance to the Dose DisplayerDose Displayer

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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.


Role:Role: Sends CT Images to the ArchiveSends CT Images to the Archive


Role:Role: Stores CT Images received from Stores CT Images received from ContourerContourer

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Worklist / Scheduling & GP WorklistWorklist / Scheduling & GP Worklist

Complete External Beam Definition of RT Complete External Beam Definition of RT PlanPlan

Multi-Modality FusionMulti-Modality Fusion

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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

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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 modiers.supported modiers.

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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

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Multi-Modality FusionMulti-Modality 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

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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

Documents

September, 2005What IHE Delivers 1 IHE-RO Radiation Oncology IHE Workshop 2006 Scott Johnson, Keith La Plain