A Telecommunications Helped Radiotherapy Planning and information System (THERAPIS) for Broad-area Maltimedia Database in Radiation Oncology

建立了一个远程通信系统，用于快速咨询CT数据、规划数据或要求从分院的放射肿瘤学家(RO)向中心医院的RO专家验证门户图像，从而为患者的隐私提供足够的安全性。在体模实验中，利用接收器工作特性(ROC)分析，比较了系统的速度和门脉图像验证的准确性。并对该系统在临床应用中的初步经验进行了评价。数字重建X线片(DRR)图像文件和6XVx线门脉图像以JPEG格式压缩1/10，并通过ISDN发送到中心医院的图像服务器。在1997年10月至1998年2月期间，49例患者的验证图像和DRR在治疗前按相同程序发送到中心医院，由放射肿瘤学家读取。通过ISDN传输24幅CT图像的传输速度为10~15min，1幅规划数据的传输速度为10min，1例患者的个人数据传输速度为1min，1幅验证图像的传输速度为7min。在49例患者中，THERAPIS诊断出2例较大的门架角度错误(&gt；10ﾟ)和6例较小的平移错误(&lt；5 mm)，并经VIEVOX检查证实。该系统足以实现与放射治疗常规方法相当的治疗验证精度。这项研究表明，远程通信有能力扩大放射治疗和放射肿瘤学家在肿瘤急诊中的作用，并共同开发专家系统。

A telecommunication system has been constructed for rapid consultation about CT data, planning data, or asking verification of portal images from radiation oncologists (RO) in branch hospital to expert RO in the central hospital keping sufficient security for patients'privacy. In this study, speed of the system and accuracy of verification of portal images was compared to the conventioal viewbox method using receiver operating characteristic (ROC) analysis in a phantom experiment. Preliminary experience in clinical practice of the system was also evaluated. The image files of the digitally reconstructed radiographs (DRR) and portal images made by 6 XV_x-ray are compressed by 1/10 using a JPEG format and sent to the images server of the central hospital through ISDN.Verification image and DRR of 49 patients were sent to the central hospital using the same procedure before tratment and read by a radiation oncologist between 1997 October and 1998 February. The transfer speed through ISDN was 10 to 15 minutes for 24 CT images, 10 minutes for one planning data, 1 minutes for one patient's personal data, and 7 minutes for one verification image respectively. In the 49 patients, 2 major set-up errors in gantry angle (>10ﾟ) and 6 minor errors in translation (<5mm) was diagnosed by THERAPIS which were cofirmed by the review of films on viewvox. The system was sufficent to achieve accuracy of treatment verification equivalent to conventional method in radiotherapy. This study suggests that telecommuncation has a capacity to extend the role of radiotherapy and radiation oncologists for oncologic emergency and mutual development of expert system.