IHERO UseCase 2011 AaronPhillips

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1. Proposed Workitem: CT study with Reference point transfer

  • Proposal Editor: Aaron Phillips, aaron.phillips@midcentral.co.nz, 646-350-8434
  • Editor: Nick Linton, nick.linton@elekta.com, 613 254-8725
  • Date: 26 Mar 2011(Wiki keeps history)
  • Version: 1.0 (Wiki keeps history)
  • Domain: Radiation Oncology

2. The Problem

A> The reference (marker) points created in Siemens syngo Dosimetrist do not transfer to CMS Monaco.

B> CMS XiO does not export CT study Date & Time (causing warning/error messages) to Siemens syngo RTT.

3. Key Use Case

A> Transfer of Points with CT study

1. The User defines Reference points on the CT study (images) during CT localization (or CT simulation) workflow

1a. Marker points are defined on CT study at patient (skin) surface

1b. A co-ordinate system Reference point is defined at the intersection of lines that connect these Marker points (A<->P & L<->R).

1c. The User marks the patient skin surface (typically with tattoos) to indicate these Marker Point locations.

1d. The User defines one (or many) Points as treatment beam isocenter(s) on the CT study (images)

1e. The User defines one (or many) Points of anatomical interest (for possible subsequent dose calculation in RTP system)

2. The User exports the CT study (images) with the defined (Markers, Reference, Interest) Points

2a. From CT localization (or Virtual simulation) system to RTP system; or/

2b. From CT localization (or Virtual Simulation) system to Treatment Management System (Oncology Information System) as possible Action points during treatment; and/

2c. From RTP system to Treatment Management System & subsequent (patient data) DICOM RT archive.


- User creates a treatment plan in CMS Monaco

- No patient reference point is seen (imported with the CT study)

- Issue: It is difficult to transfer & verify the plan geometry to the actual patient and their tattoos (reference marks) as there is no relative position from Monaco available.

B> Transfer of Date & Time:

- For every patient imaging fraction on syngo RTT the User receives a warning that there may be data inconsistencies as no Date & Time is available in the reference data set (CTs from XiO).

- If there are multiple reference data sets for multiple treatment phases (courses) or for offline Adaptive RT then it is difficult if not impossible to confirm which dataset should be used as a reference.

- Date & Time information must be made available - quite dangerous.

4. Standards & Systems


A> Various:

Siemens Syngo Dosimetrist & CMS Monaco

Siemens PET-CT & Varian Eclipse or BrainLab iPlan

B> CMS XiO and Siemens Syngo RTT


DICOM RT objects (DICOM RT PLAN, RT Stucture Set, FOR, Image Modality CT)

See also [[1]] for export of Points to Laser Marketing (Patient Positioning) system

5. Discussion

<Include additional discussion or consider a few details which might be useful for the detailed proposal>

<Why IHE would be a good venue to solve the problem and what you think IHE should do to solve it.>
<What might the IHE technical approach be? Existing Actors? New Transactions? Additional Profiles?>
<What are some of the risks or open issues to be addressed?>