IHERO 2007UseCase Instance-level Query Retrieve
Instance-Level Query/Retrieve
- RT objects from archive – review draft query key document from IHE-RO/TC meeting April 2006
- Issues
- Object (plan) linkage
- Revision management
- Query keys currently inadequate for RT objects
1. Proposed Workitem: Definition of RT Objects specific Query / Retrieve Keys
- Proposal Editor: Rishabh Kapoor
- Editor: Rishabh Kapoor
- Date: N/A (Wiki keeps history)
- Version: N/A (Wiki keeps history)
- Domain: Radiation Oncology
2. The Problem
An RT Archive is an indispensable member in a clinical workflow for the establishment of medical informatics research related to outcomes for future radiation therapy patients. It is also a system where all the patient data (Images, Plans, Dose, Structures) are securely stored. In order to retrieve the data for review / re-plan / reprocess for a follow up or provide to do research and do data mining there is a need for Query Key parameters to be passed on to the Archive in order for it to send out the objects which are matching the keys.
In IHEs other domains (Radiology, Eye Care, Cardiology) there is a list of Query keys which are required by PACS or Archive systems to support. This list of parameters can identify a patient, its study and series. In addition to these keys there are more specific keys defined for retrieving specific DICOM objects (Key Image Notes, Presentation states etc). For more information on this please refer to the IHE Radiology Technical Framework Vol 2.
In Radiation Oncology specific keys on which searching can be carried out in an RT Archive is not defined.
3. How it currently works
Many treatment planning systems currently do not have a DICOM Query / Retrieve mechanism to get treatment planning data based on basic query keys. In order to get data for such treatment planning systems, users have to work with external PACS interfaces to push the Dicom treatment planning data from the RT Archive to the TPSs. These external PACS interfaces have very basic parameters on which the data can be searched. Also there are no RT related search parameters, so again specific RT related information (RT plan description, treatment intent, treatment protocol, setup technique etc) objects can not be retrieved.
In a Radiation Therapy clinic there could be multiple RT Archive setup for specific uses. Like for example there could be a research data archive, a teaching file archive, a clinical trial archive in addition to the clinical data archive for the clinic. Some of these archive would perform functions such as patient data annomization etc. Access to treatment planning data from these multiple RT Archives could be possible only if there is DICOM Query / Retrieve mechanism in the TPS.
4. How it should works
There should be Radiation Therapy based keys with which searching an RT Archive can be done more effectively. For research, having such keys is critical in order to do data mining and report results on a large number of patients. Also this could aid in searching of treatment planning data that exceeds the tolerance parameters set by the users.
Also there needs to be a built in Q / R mechanism in the TPS for accessing multiple Archives.
5. Benefits
• With these keys defined, there is an ease to retrieve only the desired objects for a patient. So for example, with these keys we could get only the approved plans from the archive that has a list of approved and unapproved plans.
• For research, having such keys is critical in order to do data mining and report results on a large number of patients.
• Access to multiple archives could be done so to make use of clinical trials and teaching file export.
6. Standards & Systems
Affected systems:
• Treatment planning systems, virtual simulation system, record & verify systems, CT, Picture Archive and Communication Systems (RT Archive – it is not picture anymore).
Related standards
• Digital Imaging & Communication in Medicine (DICOM).
Related IHE Profiles
• IHE Radiology (Access to Radiology information profile).