RT Treatment Workflow

The Radiotherapy Treatment WorkFlow (TRWF) integrates daily imaging with radiation therapy treatments using workflow.

Summary

The Discrete Positioning and Delivery Workflow Profile involves the positioning of a patient and subsequent treatment delivery, where the positioning and delivery are performed by separate devices, as follows: • The Patient Positioning System (PPS) acquires a set of 2D (planar projection) or 3D (CT) positioning images, performs a registration with previously retrieved reference images, and repositions the patient if necessary. Note that for this profile, the output of these steps is the fact that the patient positioning has been successfully performed. • The Treatment Delivery Device (TDD) then delivers the intended treatment.

Benefits

• defines how DICOM objects for spatial registration and the images themselves are created, stored, queried, retrieved, processed and displayed
• Provides transactions required for interoperability between multi-vendor systems

Fig 3.1-1 Actors and Transactions for Discrete Positioning and Delivery Workflow.

Fig 4.1-1 Actors and Transactions for Integrated Positioning and Delivery Workflow.

Details

This Integration Profile specifies how images, RT Structure Sets, RT Doses, and associated spatial registration information can be exchanged, stored, processed and displayed. For a display workstation, it is essential that a workstation correctly identifies the corresponding image sets, matches data from single-slice and multi-slice datasets, matches coordinate systems, and performs spatial translations. The use of relevant DICOM objects (Spatial Registration) is clarified and constrained in order to avoid misinterpretation.

Image Registration Integration Profile focuses on content for image registration and does not define a registration workflow. Such workflow could be managed by using mechanisms described in the Post-Processing Workflow Integration Profile. The Image Registration Integration Profile currently only handles rigid registration. The intention is to add deformable registration as an extension to the Profile in the future.

The Image Registration Profile does not specify the use of quantification methods for the image data that is created or displayed. In particular interoperability for PET Standard Uptake Values (SUV) is considered a relevant future work item for IHE. Note that vendors may wish to prodovide SUV capability even though not required under this Profile.

Systems Affected

• Radiation Oncology PACS
• Treatment Planning Systems

Specification

Profile Status: Final Text

Documents:

IHE Radiation Oncology Technical Framework:

• Image Registration Supplement - Chapter 4 and Appendix A & B
• Radiology Image Fusion profile (FUS) - Chapter 3

Underlying Standards:

• DICOM
• DICOM-RT <add a link for DICOM-RT or DICOM Working Group 7>
• HL7

See Also

Related Profiles

• Normal Treatment Planning-Simple (NTPL-S) may use ....
• Multimodality Registration for Radiation Oncology (MMR-RO) may include ....

Consumer Information

• The REG FAQ answers typical questions about what the Profile does.
• The REG Purchasing describes considerations when purchasing equipment to deploy this Profile.

Implementer Information

• The REG Implementation provides additional information about implementing this Profile in software.

Reference Articles

<List References (good and bad) (with link if possible) to Journal Articles that mention IHE's work (and hopefully include some analysis). Go ahead, Google: IHE <Profile Name> abstract or something. You might be surprised. >

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