ORBIT-RT: A Real-Time, Open Platform for Knowledge-Based Quality Control of Radiotherapy Treatment Planning
ORBIT-RT: A Real-Time, Open Platform for Knowledge-Based Quality Control of Radiotherapy Treatment Planning
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DOI：
10.1200/cci.20.00093
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发表时间：
2021-01-29
影响因子：
4.2
通讯作者：
Moore, Kevin L.
中科院分区：
文献类型：
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作者：
Covele, Brent M.;Puri, Kartikeya S.;Moore, Kevin L.
目的 开发模型以及与不同治疗计划系统 (TPS) 集成的复杂性阻碍了基于知识的治疗计划质量控制的实现。放射治疗在线实时基准信息技术 (ORBIT-RT) 提供了一个免费的、基于网络的平台，用于基于知识的剂量估计，全世界的临床医生都可以使用该平台来衡量其放射治疗计划的质量。 材料和方法 ORBIT-RT 平台的开发是为了满足四个主要设计标准：基于网络的访问、TPS 独立性、健康保险流通和责任法案合规性以及自主操作。 ORBIT-RT 使用基于云的服务器在上传和处理病例之前自动对用户的放射治疗医学数字成像和通信 (DICOM-RT) 文件进行匿名化处理。从此，ORBIT-RT 使用已建立的基于知识的剂量体积直方图 (DVH) 估计方法，为上传的 DICOM-RT 自动创建 DVH 估计。 ORBIT-RT 性能通过由 45 个容积调制弧形治疗前列腺计划组成的独立验证集进行评估，具有两个关键指标：(i) DVH 估计的准确性（通过误差、DVH 临床 - DVH 预测进行量化）和 (ii) 在 ORBIT-RT 平台上处理和显示 DVH 估计的时间。结果 ORBIT-RT 器官 DVH 预测显示，剂量方面存在 1% 的偏差和 3% 的误差不确定性。 80% 的处方用于前列腺验证集。 ORBIT-RT 扩展每个器官需要 3.0 秒进行分析。 DICOM 上传、数据传输和 DVH 输出显示将整个系统工作流程延长至 2.5-3 分钟。 结论 ORBIT-RT 在基于网络的平台上展示了快速且完全自主的基于知识的反馈，该平台仅采用匿名 DICOM-RT 作为输入。 ORBIT-RT 系统可用于实时质量控制反馈，为用户提供最终计划 DVH 的客观比较。
PURPOSE Access to knowledge-based treatment plan quality control has been hindered by the complexity of developing models and integration with different treatment planning systems (TPS). Online Real-time Benchmarking Information Technology for RadioTherapy (ORBIT-RT) provides a free, web-based platform for knowledge-based dose estimation that can be used by clinicians worldwide to benchmark the quality of their radiotherapy plans.MATERIALS AND METHODS The ORBIT-RT platform was developed to satisfy four primary design criteria: web-based access, TPS independence, Health Insurance Portability and Accountability Act compliance, and autonomous operation. ORBIT-RT uses a cloud-based server to automatically anonymize a user's Digital Imaging and Communications in Medicine for RadioTherapy (DICOM-RT) file before upload and processing of the case. From there, ORBIT-RT uses established knowledge-based dose-volume histogram (DVH) estimation methods to autonomously create DVH estimations for the uploaded DICOM-RT. ORBIT-RT performance was evaluated with an independent validation set of 45 volumetric modulated arc therapy prostate plans with two key metrics: (i) accuracy of the DVH estimations, as quantified by their error, DVHclinical - DVHprediction and (ii) time to process and display the DVH estimations on the ORBIT-RT platform.RESULTS ORBIT-RT organ DVH predictions show, 1% bias and 3% error uncertainty at doses. 80% of prescription for the prostate validation set. The ORBIT-RT extensions require 3.0 seconds per organ to analyze. The DICOM upload, data transfer, and DVH output display extend the entire system workflow to 2.5-3 minutes.CONCLUSION ORBIT-RT demonstrated fast and fully autonomous knowledge-based feedback on a web-based platform that takes only anonymized DICOM-RT as input. The ORBIT-RT system can be used for real-time quality control feedback that provides users with objective comparisons for final plan DVHs.