IHE Radiation Oncology - BRTO-II Profile Testing

Revision 1.8 of the BRTO-II Profile (Trial Implementation, updated 8/3/18) will be tested at the IHE-RO 2018 Connectathon.

The BRTO-II Profile supports basic workflow for 3D conformal treatment planning. BRTO-II Profile Actors are tested in sequence (Contourer → Dosimetric Planner → Dose Displayer) using several patient datasets. For each transaction in this sequence, each producer Actor is to be tested with three downstream consumers. Similarly, each consumer Actor is to demonstrate successful acceptance of data from three upstream producers.

BRTO-II Test Datasets

# Patient ID Desciption Scan
10 BRTO18A10xx Multi-series CT test (Contourer only) HFS
11 BRTO18A11xx Head/neck patient HFS
12 BRTO18A12xx Prostate patient HFS
20 BRTO18A20xx Anal-canal patient (treat FFP) HFP
21 BRTO18A21xx Phantom (treat FFS) FFS
22 BRTO18A22xx Phantom (decubitus-left) HFDL


BRTO-II Options

# Option Archive Contourer Dos. Planner Dose Disp.
1 Off-slice Structure Set Storage * O O O -
2 Off-slice Structure Set Retrieval O O O O
3 Structure Set Retrieval R O R R
4 Resampled/Combined CT Series Storage * O O - -
5 DVH Dose Storage * O - O -
6 DVH Dose Retrieval O - - O
7 Geometric Plan Retrieval O - O -
8 Feet First Scan Support * - O O -
9 Reoriented (HF/FF) Support * - - O -
10 Decubitus Support * - O O -

* Producer Actors should indicate if these Options were used in the Series Description of objects stored.

Acquisition Modality

The BRTO-II Acquisition Modality Actor is the producer of planning CT images. Test datasets are provided in place of data produced by this Actor.


Contourer

Create contours of your liking (preferably something that can be easily compared on another system, e.g. bony structures). Please create at least one target (“GTV”, “PTV”) and at least one normal structure (“Bone”, “Rectum”, etc.).

  1. HFS CT Series Contouring Test - Create and store contours on each of these datasets. Use each of these datasets for comparison with at least one consumer Actor:
    • BRTO18A11xx: Import BRTO - Head & Neck patient CT series. Create contours. Export RT Structure Set.
    • BRTO18A12xx: Import BRTO - Prostate patient CT series. Create contours. Export RT Structure Set.
  2. Non-HFS CT Series Contouring Test - Create and store contours on each of the non-HFS datasets below. Use each of these datasets for comparison with each consumer Actor:
    • BRTO18A20xx: Import HFP Anal canal patient CT series. Create contours. Export RT Structure Set.
    • BRTO18A21xx: Import FFS Rando Phantom CT series. Create contours. Export RT Structure Set.
  3. CT Resampling Test (OPTIONAL)
    • BRTO18A10xx: TBD
  4. Decubitus Scan Support (OPTIONAL)
    • BRTO18A22xx: Import Decubitus patient CT series. Create contours (see instructions for Dosimetric Planner below). Export RT Structure Set.

Note that xx is the vendor code identifying the Contourer Actor.

Consumption of RT Structure Sets produced by Contourer Actors may be tested using any of the following BRTO-II Actors:

  • Contourer
  • Dosimetric Planner
  • Dose Displayer



Dosimetric planner

Import a CT series and an RT Structure Set that has been exported by a BRTO-II Contourer Actor. Create a dosimetric plan using the IHE_V120 treatment delivery machine specification for each of the datasets shown below.

  • Use the IHE_V120 machine specification.
  • Use a prescription for 4500 cGy (45 Gy) total dose, delivered in 25 fractions, i.e., 180 cGy/fraction.
  • Calculate dose, and export the RT Plan and RT Dose to the Archive. If possible, create non-square dose grids (unequal in-plane row and column spacing) and non-uniform grid-frame offsets.
  • Please identify the vendor of the dosimetric planner actor in the Series Description of the RT Plan and RT Dose instances produced and stored in the Archive. (e.g., “DP=VA”).

Perform the following tests:

  1. HFS Dosimetric Plan Test - Create and export a dosimetric plan and dose instance for each of these datasets:
  2. Non-HFS Dosimetric Plan Test - Create a dosimetric plan for each of these datasets:
    • BRTO18A20xx: Import HFP Anal-canal patient CT series and RT Structure Set. Create a dosimetric plan for this dataset in which the patient is treated FFP. Export the Dosimetric Plan (RT Plan) instance.*
    • BRTO18A21xx: Import FFS Rando Phantom CT series and RT Structure Set. Create and export a geometric plan for this dataset.

Consumption of plans produced by Dosimetric Planner Actor is tested using a BRTO-II Dose Displayer Actor. At least one HFS and one non-HFS geometric plan is to be used for each comparison.

* Note: inability to handle plans involving FFP treatment position using HFP scans is not grounds for failure of this test.


BRTO18A11xx

Place the isocenter on the slice at Z=16mm, shown below. Position the isocenter to enclose the target as well as possible with the fields specified in the table below.

Gantry angle AP Right Lat
Collimator angle 0 45
Table angle 0 30
Field size 10 x 10 X1=-2, X2=15, Y1=-5, Y2=18

Export the dosimetric plan and dose to the archive.

BRTO H/N Patient


BRTO18A12xx

Use the isocenter defined by the point in one of the gold seeds. Use the field definitions shown below.

Gantry angle AP Right Lat
Collimator angle 0 45
Table angle 0 30
Field size 10 x 10 X1=-2, X2=15, Y1=-5, Y2=18

Export the dosimetric plan and dose to the archive.

BRTO Prostate Patient

[NEED TO CHECK FIELD DEFINITIONS FOR NON-HFS CASES: BRTO18A20xx and BRTO18A21xx]


BRTO18A20xx

Place the isocenter on the slice at Z=174mm, shown below. Position the isocenter to coincide with the ROI labeled “CBCT ISO”. Use the fields specified in the table below.

Gantry angle AP Right Lat
Collimator angle 0 45
Table angle 0 30
Field size 10 x 10 X1=-2, X2=15, Y1=-5, Y2=18

Export the dosimetric plan to the archive.

BRTO HFP Anal Canal


BRTO18A21xx

Place the isocenter on the slice at Z=-208mm, shown below. Position the isocenter at the marker as shown below, with the fields specified in the table below.

Gantry angle AP Right Lat
Collimator angle 0 45
Table angle 0 30
Field size 10 x 10 X1=-2, X2=15, Y1=-5, Y2=18

Export the dosimetric plan and dose to the archive.

BRTO FFS Rando


BRTO18A22xx (Optional)

Place the isocenter at (116, 0, 166) on the slice at Z=166mm. Draw a GTV approximately 4cm in diameter at this location and contour the right and left femurs. Align the isocenter using the BBs as shown below, with the fields specified in the table below.

Gantry angle Right Lat AP
Collimator angle 0 45
Table angle 0 30
Field size 10 x 10 X1=-2, X2=15, Y1=-5, Y2=18

Export the dosimetric plan and dose to the archive.

BRTO HFDL Rando



Dose Displayer

Compare CT images, RT Structure Set and RT Dose from a Dosimetric Planner for at least one HFS and one non-HFS dataset from each upstream Producer.

  • Import CT images, RT Structure Set, and RT Dose export from a Dosimetric Planner Actor.
  • Display the same patient dataset on the Dosimetric Planner that produced the plan.
  • Compare displays of structure contours to imaged anatomy on all slices containing that structure.
  • Find the slice containing the Isocenter.
  • Compare 20, 50, and 90% isodose contours on both Dosimetric Planner and Dose Displayer.
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