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IHE Radiation Oncology - BRTO-II Profile Testing

Revision 1.11 of the BRTO-II Profile (Trial Implementation, updated 4/5/19) will be tested at the IHE-RO 2023 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 BRTO23A10xx Multi-series CT test (Contourer only) HFS
11 BRTO23A11xx Head/neck patient HFS
12 BRTO23A12xx Prostate patient HFS
20 BRTO23A20xx Anal-canal patient (treat FFP) HFP
21 BRTO23A21xx Phantom (treat FFS) FFS
22 BRTO23A22xx 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.


General Instructions

Contourer

Create contours as described below for each BRTO-II dataset (some datasets are optional based on the options you are testing). When adding contours to an RT Structure set previously created by another vendor, add “_XX_” to the Series Description to help in tracking.

  1. HFS CT Series Contouring Tests - Create and store contours on each of these datasets. Use each of these datasets for comparison with at least one consumer Actor.
  2. HFP, FFS CT Series Contouring Tests - Contourers supporting non-HFS orientations should create and store contours on these datasets. If possible, 3 consumers should validate the contours created across these datasets.
  3. HFDL CT Series Contouring Test - Contourers supporting the decubitus orientation should create and store contours on this dataset. If possible, 3 consumers should validate the contours created.
  4. CT Resampling Test - Contourers supporting multiple series import should create and store contours and the combination CT series. If possible, 3 consumers should validate the CT series and contours created.

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

Image Import Judging Criteria:

  • Correct number of images imported
  • Slice resolution, spacing consistent
  • Image Orientation Correct
  • For Multi-Series, number of slices and spacing of composite image series

Structure Set Import/Export Judging Criteria:

  • Consistency of Structures imported (number of structures, # of contours, association with correct slice, structure color)
  • Structure shapes and positions match structure creator



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.

  • 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:
    • BRTO<YY>A20xx: 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.*
    • BRTO<YY>A21xx: Import FFS Rando Phantom CT series and RT Structure Set. Create and export a geometric plan for this dataset.
  3. Decubitus Plan Test - Create and export a dosimetric plan and dose instance for each of these datasets
    • BRTO<YY>A22xx: Import the HFDL 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.

Dosimetric Plan Import/Export Judging Criteria:

  • Consistency of Isocenter Point
  • Consistency of Field Parameters (field identification, gantry, collimator, table positions, jaw positions, SSDs)
  • Consistency of Dose Parameters (prescription, dose matrix, maximum dose, isodose lines, MU, heterogeniety correction)


Specific Contouring and Planning Instructions.

BRTO<YY>A10xx

Contourers:

           Import the BRTO - Multi-Series patient CT series.  
           Create an ROI across the boundary between the two series.  Contours should be present on at least 6 slices.
           Export the RT Structure Set and new CT Series (combined) to the archive.
BRTO<YY>A11xx

Contourers:

           Import the BRTO - Head & Neck patient CT series.  
           Draw a PTV approximating the right parotid (as shown below) on several slices 
           Contour the Skin (external), spinal cord on all appropriate slices, as shown below.  
           Export the Structure Set to the archive.  

Dosimetric Planners:

           Import the Head & Neck dataset and Structure Set.
           Use the IHE_V120 machine specification.
           Align the isocenter using the BBs. 
           Create a plan using the fields below.
           Create a dose matrix encompassing the entire phantom
           Calculate dose to give 180 cGy/fraction to the right Parotid in 25 fractions.
           Export the RT Dose and RT Plan to the Archive.
Field Name Lt Obl Rt Lat
Gantry Angle 45 270
Collimator angle 0 45
Table angle 0 5
Field size X1=-6, X2=-2, Y1=-3.0, Y2=3.0 X1=-2, X2=3, Y1=-2.5, Y2=2

BRTO H/N Patient


BRTO<YY>A12xx

Contourers:

           Import the BRTO - Prostate patient CT series.  
           Align the isocenter as shown in the image below. 
           Draw a PTV approximating the prostate (as shown below) on several slices. 
           Contour the Skin (external), right and left femurs, as shown below.  
           Export the Structure Set to the archive.  

Dosimetric Planners:

           Import the BRTO - Prostate dataset and Structure Set.
           Use the IHE_V120 machine specification.
           Align the isocenter as shown in the image below. 
           Create a plan using the fields below.
           Create a dose matrix encompassing the entire phantom
           Calculate dose to give 180 cGy/fraction to the prostate in 25 fractions.
           Export the RT Dose and RT Plan to the Archive.
Field Name AP Rt Oblique
Gantry angle 0 300
Collimator angle 0 20
Table angle 0 5
Field size 14 x 10 X1=-5.5, X2=3, Y1=-2.5, Y2=3.5

BRTO Prostate Patient


BRTO<YY>A20xx

Contourers:

           Import the BRTO - HFP Anal Canal patient CT series.  
           Draw a PTV approximating the target volume 1cm above and below the isocenter slice. 
           Contour the Skin (external), right and left femurs.  
           Export the Structure Set to the archive.  

Dosimetric Planners:

           Import the BRTO - HFP Anal Canal dataset and Structure Set.
           Use the IHE_V120 machine specification.
           Align the isocenter as shown in the image below. 
           Create a plan using the fields below and treating the patient in the FFP position.
           Create a dose matrix encompassing the entire phantom
           Calculate dose to give 180 cGy/fraction to the isocenter in 25 fractions.
           Export the RT Dose and RT Plan to the Archive.
Field Name PA Rt Lat
Gantry angle 0 90
Collimator angle 0 45
Table angle 0 10
Field size 10 x 10 X1=-2, X2=4, Y1=-4, Y2=3

BRTO HFP Anal Canal


BRTO<YY>A21xx

Contourers:

           Import the BRTO - FFS Rando CT series.  
           Draw a PTV approximately 3cm in diameter and length around the isocenter. 
           Contour the Skin (external), right and left lungs.  
           Export the Structure Set to the archive.  

Dosimetric Planners:

           Import the BRTO - FFS Rando dataset and Structure Set.
           Use the IHE_V120 machine specification.
           Align the isocenter as shown in the image below. 
           Create a plan using the fields below.
           Create a dose matrix encompassing the entire phantom
           Calculate dose to give 1000 cGy/fraction to the prostate in 1 fractions.
           Export the RT Dose and RT Plan to the Archive.
Field Name AP Rt Lat
Gantry angle 0 R90
Collimator angle 0 45
Table angle 0 350
Field size 10 x 10 X1=-4, X2=6, Y1=-3, Y2=4

BRTO FFS Rando


BRTO<YY>A22xx (Optional)

Contourers:

           Import the Decubitus dataset.  
           Draw a GTV approximately 4cm in diameter and 4cm long centered at this location. 
           Contour the Skin (external), right and left femurs on all appropriate slices, as shown below.  
           Export the Structure Set to the archive.  

Dosimetric Planners:

           Import the Decubitus dataset and Structure Set.
           Use the IHE_V120 machine specification.
           Align the isocenter using the BBs. 
           Create a plan using the fields below.
           Create a dose matrix encompassing the entire phantom
           Calculate dose to give 1000 cGy to the isocenter in a single fraction.
           Export the RT Dose and RT Plan to the Archive.
Field Name Rt Lat AP
Gantry angle 0 90
Collimator angle 0 45
Table angle 0 0
Field size 10 x 10 X1=-2, X2=7, Y1=-5, Y2=7

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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