The BRTO Profile supports basic workflow for 3D conformal treatment planning. BRTO Profile Actors are tested in sequence (Contourer → Geometric Planner → 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.

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

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. CT Series Merge Test
   • BRTO15A10xx: Import and merge the two image Series. Create contours. Export (a) merged CT Series and (b) RT Structure Set. (TestTools scenario: ContourerScenario2)
2. 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:
   • BRTO15A11xx: Import BRTO - Head & Neck patient CT series. Create contours. Export RT Structure Set.
   • BRTO15A12xx: Import BRTO - Prostate patient CT series. Create contours. Export RT Structure Set.
3. 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:
   • BRTO15A20xx: Import HFP Anal canal patient CT series. Create contours. Export RT Structure Set.
   • BRTO15A21xx: Import FFS Rando Phantom CT series. Create contours. 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 Actors:

• Contourer
• Geometric Planner
• Dosimetric Planner
• Dose Displayer

Import a CT series and an RT Structure Set that has been exported by a BRTO Contourer Actor. Create a geometric plan using the IHE_V120 treatment delivery machine specification for each of the datasets shown below. Please identify the vendor of the geometric planner actor in the Series Description of the RT Plan produced and stored in the Archive.

1. HFS Geometric Plan Test - Create and export a geometric plan for each of these datasets:
   • BRTO15A11xx: BRTO - Head & Neck patient.
   • BRTO15A12xx: BRTO - Prostate patient CT series.
2. Non-HFS Geometric Plan Test - Create a geometric plan for each of these datasets:
   • BRTO15A20xx: Import HFP Anal-canal patient CT series and RT Structure Set. Create a geometric plan for this dataset in which the patient is treated FFP. Export the Geometric Plan (RT Plan) instance.*
   • BRTO15A21xx: Import FFS Rando Phantom CT series and RT Structure Set. Create and export a geometric plan for this dataset.

Consumption of plans produced by Geometric Planner Actor is tested using a BRTO Dosimetric Planner 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.

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.

Export the geometric plan to the archive.

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

Export the geometric plan to the archive.

[NEED TO CHECK FIELD DEFINITIONS FOR NON-HFS CASES: BRTO15A20xx and BRTO15A21xx]

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.

Export the geometric plan to the archive.

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.

Export the geometric plan to the archive.

Import a CT series, RT Structure Set, and geometric plan generated by another vendor for each of the datasets listed below.

1. HFS Geometric Plan Test:
   • BRTO15A11xx: BRTO - Head & Neck patient.
   • BRTO15A12xx: BRTO - Prostate patient CT series.
2. Non-HFS Geometric Plan Test:
   • BRTO15A20xx: HFP Anal-canal patient (treated FFP*).
   • BRTO15A21xx: FFS Rando Phantom.

Create a dosimetric plan for each dataset.

• 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 use the Series Description of the RT Plan and RT Dose to identify the vendor of the geometric planner whose plan was consumed and the dosimetric planner whose plan was produced and stored in the Archive (e.g., “GP=PH, DP=VA”).

* Note: inability to handle plans involving FFS treatment position using HFS scans will be noted, but is not grounds for failure of this test.

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.