Quality Reports With. PlanIQ. *Export only. 510(k) pending. Patent pending. Your Most Valuable QA and Dosimetry Tools

Transcription

1 Quality Reports With PlanIQ * *Export only. 510(k) pending. Patent pending. Your Most Valuable QA and Dosimetry Tools

2 Objective Plan Assessment? How good are my treatment plans? Quality assurance of radiation therapy treatment plans has historically focused on verifying the accuracy of dose delivery, and there are wellestablished methods for doing so. However, when it comes to the quality of the plan itself, the methods are subjective and heavily dependent on the clinical staff involved until now. Quality Reports with PlanIQ leverages technology to capture the wisdom of the clinical team and combine it with patient-specific anatomy to deliver an immediate measure of plan quality. The effectiveness of this solution allows the clinical team to create the best plan possible for each patient in a fraction of the time required by existing methods. Achievability of Plan Objectives Plan Quality Metrics Prior to the start of plan design, see estimated achievability of the dose and DVH objectives based on the specific patient s anatomy. A realistic and agreed-upon expectation for each patient s plan improves communication and reduces treatment planning time. Plan quality metrics are automatically generated from the DICOM files and adjusted to reflect patient-specific anatomical challenges. Objective and patient-specific analytics allow clinicians to create the best plan possible for each patient. I like the way it works and flows. The software and analysis have already impacted the way that we plan, so it is making a clinical difference. Lou Nardella Medical Physicist Pocono Medical Center 2

3 Improved Workflow? How can I improve the plan review, approval, and documentation process? Despite all of the improvements in treatment planning and dose delivery, little has changed in the way that plans are reviewed, approved, and documented. Dose points from the plan are manually compiled and compared to the prescription. Simplistic pass/fail results for each DVH goal are subjectively weighted and negotiated. Documentation for patient-specific cases is collected from multiple, inconsistently formatted sources and manually compiled. This process is time consuming and can result in errors. Quality Reports addresses these challenges with automation and innovation, providing tools that foster better communication, increase data integrity, and save time. Plan Approval Plan Documentation Objectives defined by the physician are compared to the actual result, and a score is calculated for each target or structure and for the plan as a whole. Treatment planners can optimize their plan, working within the protocol guidelines, to achieve objectives while reducing consultation and review cycles. Equipping the treatment planner with more information earlier in the process enables a more efficient plan approval process for all. All documentation regarding the patientspecific plan, including objectives, metrics, adjusted metrics, approvals, and details regarding the entire prescription are obtained through DICOM files and compressed into a detailed report. Standardized reports can be customized for each clinic s specific requirements and for auditor review. Automation saves time and ensures that required reports are compliant. Quality Reports adds value by providing the tools to objectively evaluate treatment plans regardless of physician or planner. Each plan is evaluated with the same criteria every time. It enables us to evaluate a plan, decide if there are objectives that can be improved upon, then re-plan and rescore. This creates a continuous quality improvement environment throughout the practice. Rebecca McInturf Chief Therapist/Dosimetrist Cancer Care Centers of South Texas 3

4 Demonstrate Continual Improvement The ability to create performance distributions is built into Quality Reports. There is no limit on the number of distributions that can be created and maintained. A typical application of this feature is to set up a discrete distribution for each protocol to track historical results of plan quality when using the particular protocol. Alternatively, statistics can be compiled to compare the results of using different treatment planning systems, treatment delivery systems, or treatment modalities. Another application is to assist with the commissioning of auto-planning systems by ensuring plan data is high quality. Get instant feedback on treatment plans relative to prior plans for the same treatment site Drive consistency, mitigate risk, and facilitate compliance and accreditation Demonstrate continual improvement and maintenance of certification projects Assist with commissioning of auto-planning systems 4

5 Features and Benefits Plan Quality Algorithm The Nucleus of Quality Reports Each Plan Quality Algorithm captures and automates a clinical protocol, including all the variance acceptable criteria that are recommended by the protocol. A typical protocol in Quality Reports will require one Plan Quality Algorithm instead of spreadsheet variations. This template reflects a typical clinical brain case Objectives and constraints for each target or structure are encoded as components of the algorithm A maximum score is defined for each component to express the priority of meeting the objective Ideal, Acceptable, and Unacceptable results are color-coded for easy reference Multi-dose Composite The entire course of planned treatment for radiotherapy patients often includes multiple plans (of the same or differing modalities) that are delivered either simultaneously or sequentially. In order to know the combined effect of all plans, it is necessary to combine the dose grids for a composite review of the plan. Quality Reports allows for a composite dose to be easily and quickly created and saved in a new RT Dose file for subsequent reuse in Quality Reports or elsewhere. DVH QA Audit DVH calculations and parameters for Treatment Planning System QA, as recommended in TG-53. Easy documentation for reports and accreditation review. 3DVH Integration Combining the power of 3DVH and Quality Reports allows the clinician to facilitate and document the complete cycle of per-patient QA using consistent, quantitative measures of success. After the Dose QA measurements are taken and analyzed with 3DVH, automatically transfer the 3DVH analysis and the patient DICOM set directly to Quality Reports for scoring and comparison to the original approved treatment plan scoresheet. Physics Checklist Customize and save a library of non-dosimetric plan parameters of interest and compare them against pre-set constraints. Quick checks for grid resolution and size, noncoplanar beams, MU limits (per plan or beam), number of beams, beams with collimator angles, and many more. 5

6 Software Empowers the Clinical Team in the Planning Process Based on anatomy and target prescriptions, quantify the difficulty level per metric goal, allowing for more realistic expectations prior to the design of a treatment plan. Achievability of acceptable goals Achievability of ideal goals PlanIQ generates an Ideal dose coverage to the target volume and then calculates other structure metric results based on that dose distribution Each target and structure includes an achievability level for the clinical objectives (Achievable, Challenging, Potentially Impossible) 6

7 A Better Way to Review Treatment Plans Now all treatment plans can be compared more effectively regardless of modality or patient-specific anatomical challenges. The Adjusted Plan Quality Metric (APQM) is a robust measure of plan quality that factors out patient-specific anatomical challenges The Max Score reflects the total number of points available for each metric The Raw Score reflects the number of points earned for each metric according to the weighting established by the clinic in the Plan Quality Algorithm Each Result is calculated based on information extracted from RT Structure, RT Dose, and RT Plan files 7

8 Comprehensive and Customized Reports with a Single Click Reports vital to billing, compliance, and accreditation are created automatically from DICOM files and Quality Reports plan analytics. Templates allow the clinic to define the content and the aesthetics of the reports to ensure consistency and ease-of-use. As an accredited site since 2001, we have seen many changes to the recommendations. Currently, credentialing bodies such as ACR and ASTRO heavily emphasize comprehensive documentation of the treatment plan, including a dose constraint summary and verification that the results of the plan were in alignment with the physician s exceeded the expectations of the specified requirements because Quality Reports is part of our daily practice. I would intent. Thankfully, we were using Quality Reports to capture this information within our clinical workflow. We easily recommend this application to anyone considering going through the accreditation process. Recommended Publication Thomas W. Dellinger, DABR, PE Medical Physicist Comprehensive Cancer Center Variation in external beam treatment plan quality: An inter-institutional study of planners and planning systems, B. Nelms, et al., Practical Radiation Oncology 2012 Oct;2(4): System Requirements Compatibility Operating System: CPU: Hard Drive Space: RAM: Display Resolution: Windows 7, Windows 8.1, and Windows Server 2008 (32-bit installer for Windows XP is available) Recommended 2.4 GHz or better, multi core (2 or more cores) Software - Recommended 20 MB DICOM Archive GB 2 GB x number of cores (e.g. 8 GB for 4 cores) 1600 x 900 pixels or better Screen resolution Compatible with all TPS that can export DICOM files One-click export and import for sharing protocols and Plan Quality Algorithms RTOG-based Plan Quality Algorithms are available for import All reports can be loaded into any EMR system for billing, compliance, and accreditation QualityReports_PlanIQ_D Corporate Headquarters 3275 Suntree Boulevard Melbourne, FL USA sunnuclear.com