MIM USER GUIDELINES FOR TROG QUALITY ASSURANCE DOSE REVIEW Version 3 May 2015
Contents 1 Welcome... 3 2 TROG QA Support... 3 3 Opening MIM... 3 3.1 Access to CQMS... 3 3.2 Access to MIM via Citrix... 4 3.2.1 Citrix Troubleshooting... 5 3.3 Open MIM... 6 3.3.1 Firewall Issues... 7 3.4 Log in to MIM... 7 4 Opening the Patient... 8 4.1 Patient List... 8 4.2 QA Review Session... 8 5 Navigating MIM... 10 5.1 Menu Sidebars... 10 5.2 Changing the Display... 10 5.3 Dose Sidebar... 11 5.3.1 Dose Display... 11 5.3.2 Dose Prescription... 12 5.3.3 Dose Volume Constraints... 12 5.3.4 Dose Volume Histogram... 13 5.4 Radial Menu... 15 5.5 Keyboard Shortcuts... 16 6 Saving in MIM... 16 7 Exiting MIM... 17 8 Completing the CQMS Audit Form... 17 Page 2 of 19
1 Welcome Welcome to the TROG user guidelines for MIM. These guidelines contain an overview of the TROG QA review process using MIM software. These guidelines are not intended to provide a complete overview of the features of MIM, but rather an outline of how MIM should be used to conduct TROG QA technical dose reviews. If you require any further information on how to create contours and include annotations please refer to the MIM User Guidelines for Contour Review. 2 TROG QA Support Please do not hesitate to contact the QA office for further training and assistance: Phone: +61 (0)2 40143911 Email: QA@trog.com.au 3 Opening MIM MIM is accessed through the TROG Citrix platform via CQMS. 3.1 Access to CQMS CQMS is accessed via a secure log-in on the TROG website www.trog.com.au Click on the link at the top of the TROG homepage to access the CQMS log-in page Page 3 of 19
Enter your CQMS login details into the specified fields If you do not have a login or have any issues please contact the Helpdesk (qa@trog.com.au) 3.2 Access to MIM via Citrix Click on the Citrix (CRG) icon, which will take you to the Citrix log-in page Enter your username and password into the specified fields Page 4 of 19
3.2.1 Citrix Troubleshooting The first time you login into Citrix, your computer may not have the correct client software installed. Follow the instructions on the page to install the software There may be workplace network restrictions in place and you will need your IT person to complete the installation To install, click on Run, or Save if you need IT to load the file You may need to also install and add-on (Wfica from Citrix Systems) Page 5 of 19
To allow this to happen you may need to enable ActiveX Control 3.3 Open MIM Click on the MIM icon Page 6 of 19
The MIM icon may not be able to be visualised and you might need to go back by selecting the Up icon The Up icon lets you move up through the file/folder tree. Refresh your page Clicking on the key allows you to change your password. Go back to checking on your client software Help 3.3.1 Firewall Issues If there are issues with the firewall at your site, this becomes obvious at the MIM loading stage. If you have issues at this stage your IT person will need to allow access to: https://citrix.trog.com.au/citrix/accessplatform/site/default.aspx 3.4 Log in to MIM Log in to MIM using your CQMS/Citrix username and password Page 7 of 19
4 Opening the Patient 4.1 Patient List Patient data is stored in trial-specific MIMPacs folders You will only have access to the specific trials you require. Double click on the trial folder of interest From the patient list, click once on the appropriate patient for review Available data for each patient is listed on the right hand side of the screen (i.e. the radiotherapy treatment planning data including the CT dataset, dose, planning, and structure file/s). Stored data might also include diagnostic CT datasets, PET datasets and Cone Beam CTs. 4.2 QA Review Session For each review, the TROG QA office will set up a saved SESSION for you to access. This session will include: o o o o o Trial specific dose volume constraints Trial specific reporting templates Standardised contour naming conventions Relevant isodose values Pre-set displays to optimise and streamline the review process Page 8 of 19
If multiple sessions are saved, a + icon will precede the session file, with the latest version displayed. To reveal previously saved sessions, select the + symbol The session to be used for review will be named INITIAL REVIEW Highlight the INITIAL REVIEW session and select Open The patient for review will now open Page 9 of 19
5 Navigating MIM 5.1 Menu Sidebars Menu sidebars are located along the left hand side of the screen and can be accessed by clicking on the sidebar of interest 5.2 Changing the Display Select the desired display window The display will appear on the computer screen Add each view (axial, sagittal, coronal) to the windows of the computer screen by a single left mouse click Select the Create tab to populate Page 10 of 19
Each time a new display is created, it is added as a window at the top of the screen in red. Click to view previous displays 5.3 Dose Sidebar 5.3.1 Dose Display A trial-specific pre-set selection of isodose values will be prepared and saved by TROG QA To add isodose values select the + icon All isodose values should be in absolute dose (Gy) Colourwash can also be used Turn isodose values on and off select the eye icon Turn phases on and off select the eye icon next to each phase and un-check the tick box Page 11 of 19
5.3.2 Dose Prescription The Prescription Dose displayed in MIM is typically the maximum dose of the plan and not the prescribed dose. The source of this dose value will always be defined e.g. (Max), (RT plan) etc. 5.3.3 Dose Volume Constraints Trial specific dose constraints are displayed A green tick indicates that protocol requirements have been met A red circle indicates that protocol requirements have not been met o These values are automatically populated to aid review, however all reviewers must use this ONLY as a supplement to the overall assessment of dose constraints. It is your responsibility to ensure the correct volumes are selected and assessed Page 12 of 19
5.3.4 Dose Volume Histogram The DVH can be calculated by selecting the DVH icon Please ensure you only select the DVH icon next to the phase of interest Choose the structures to display on the MIM-Generated DVH Page 13 of 19
The generated DVH will open in a new window Points of interest on the DVH can be located using the annotation tool o Highlight the structure of interest (a red outline will appear around the structure) o Select Add Annotation and define the dose or volume value that you wish to view The annotation will now appear as shown below Page 14 of 19
5.4 Radial Menu and Tools Tools can be accessed at the of the page or via the radial menu To access the Radial Menu right click and then select the shaded quarter of the oval Icon Function Notes Save Session Use at end of review save your session as: INITIALS_DOSE REVIEW Structured Report Measure To provide feedback to sites. Add screen captures, dose constraint results and comments Capture viewport Take a screen capture of the active window Rotate view Contrast Pan Zoom Page 15 of 19
Annotate To provide feedback 3D Brush 2D Brush Image Grid 3D Brush+ Right click and pan - Increase or decrease brush diameter 2D Brush+ Right click and pan- Increase or decrease brush diameter To show multiple slices in consecutive order (for the purposes of creating a screen capture) 5.5 Keyboard Shortcuts Keyboard Function Notes 1,2,3 Zoom Zooms display by factor of 1,2,3 E Localise Enter Dicom Co-ordinates Access MIM tools See below Add tools to the toolbar, search for additional tools Type keywords in the textbox at the top of the drop down menu to search for tools 6 Saving in MIM Please note: MIM and Citrix will time out if left idle. SAVE your work in a session for easy retrieval Any changes made for the purpose of review that you wish to save e.g. creation of isodose lines, annotations, screen captures etc. can be kept by saving a DOSE REVIEW session To identify sessions, please use the naming convention YOUR INITIALS_DOSE REVIEW If you exit MIM and continue your review at a later time, select your saved session and then Open All additional changes/edits will need to be saved each time in a new session When the review is complete, please be aware only the most recent DOSE REVIEW session will be kept. Previously saved sessions with the same name will be deleted by TROG QA Page 16 of 19
7 Exiting MIM When you wish to exit MIM or close the session: o Select Sessions o Click on the red cross o MIM will prompt you with Really? click on the red cross again o Select No when asked to perform final save of contours 8 Completing the CQMS Audit Form An Audit Form will be allocated to you in CQMS. This Audit Form contains the review questions that will be used as feedback to the treating clinician in the form of a QA Case Report. Please log in to CQMS via the TROG website: www.trog.com.au Click on the blue Audit Form link, located under Audit Page 17 of 19
When you click on the link you will be taken to the form for that patient Expand each section of the form by clicking on Expand All The audit form contains a listing of the files that have been uploaded from the site All JPEG images, word and PDF documents will be listed under the Files tab To view a document or image, simply click on the file name and the image or document will open in a new window Page 18 of 19
Please complete the questions in the relevant sections Once you have completed the review select Yes; form complete in the REVIEW COMPLETE section at the bottom of the page Enter your name, date of the review (dd/mm/yyyy) and any comments you wish to have relayed to the treating clinician Select Save This will remove the audit form from your CQMS desktop Page 19 of 19