IHE-RO Dose Compositing (DCOM) Profile Actors are tested using the patient datasets listed in the table below.

vv = Vendor code for the Registrator Actor

Each of these datasets contains two CT image series with associated contours, plan, and dose. A Spatial Registration Object containing a (rigid) registration between the Frames of References of the two image series.

Be sure to use each of the three patient datasets at least once.

Preparation

1. Import datasets from patients 3,4. Be sure to use each of these datasets at least once.

Testing For each imported patient, the Tester must do the following:

1. Register the image Series.
2. Combine the registered doses (using simple addition, if possible)
3. Export the resulting composite dose in the “Primary” Frame of Reference (FoR with the Identity transformation in the Spatial Registration object.)

Evaluation For each patient dataset, evaluate the composite dose using a General Dose Viewer or Registered General Dose Viewer Actor:

1. Import the CT image series and RT Structure Set (from the Primary Frame of Reference), as well as the composite dose produced by the Registered Dose Compositor
2. For patients 3 and 4, check that the composite dose is consistent with an overlap of dose for the two single-beam plans (one with an AP beam, the other with a Lateral beam). See figure below.
3. If available, compare the Registered Dose Compositor display to the Dose Viewer display.

Preparation

1. Import datasets from patients 1,3,4.

Testing For each imported patient, the Tester must do the following:

1. Register the image Series.
2. Starting with one of the CT image series and RT structure set, create a new plan using the dose in the other frame of reference as a “Prior” dose.
3. Export the resulting plan dose and composite dose instances in the Frame of Reference of the new plan.
4. Try using the “primary” CT (Series in the FoR of the Identity transformation in the Spatial Registration object) for one patient and the “secondary” CT (Series in the non-identity transform in the SRO) for the another patient.

Evaluation For each patient dataset, evaluate the plan dose and composite dose using a General Dose Viewer or Registered General Dose Viewer Actor:

1. Import the CT image series and RT Structure Set, and the composite dose produced by the Registered Compositing Planner into the viewer
2. Compare the Registered Compositing Planner display to the Dose Viewer display
3. If possible, check consistency of isodose contours at 20, 50, and 90% of maximum dose.

Preparation

1. Import Composite Dose datasets produced by a Registered Dose Compositor or Registered Compositing Planner Actor for patients 1,3,4 (including CT images and RT Structure Sets).

Evaluation For each patient dataset, compare the General Dose Viewer display with the display of the Actor that produced the dose.

1. Check for consistency in the spatial registration of images, structure sets and dose, as well as consistent distribution and scaling of doses.
2. If possible, compare isodose contours at 20, 50, and 90% of maximum dose.

Preparation

1. Import Composite Dose datasets produced by a Registered Dose Compositor or Registered Compositing Planner Actor for patients 1,3,4 (including CT images, RT Structure Sets, and Spatial Registrations).

Evaluation For each patient dataset, compare the General Dose Viewer display with the display of the Actor that produced the dose.

1. Check for consistency in the spatial registration of images, structure sets and dose, as well as consistent distribution and scaling of doses.
2. If possible, compare isodose contours at 20, 50, and 90% of maximum dose.
3. Assure that the dose can be displayed correctly in both the primary and secondary frame of reference.

The Dose Compositing (DCOM) Profile defines the relevant standards and constraints needed for the purpose of combining or compositing spatially-related radiation doses. The spatial relationship between doses is defined by a rigid transformation encoded in a DICOM Spatial Registration object. The process of combining two 3-D dose matrices may involve resampling, scaling, or transformations needed to account for differing fractionation and radiation type.

Two Use Cases are supported by two distinct Actors in this profile. Both involve accepting dose matrices, each defined in its own frame of reference, as well as Spatial Registration object(s) relating those frames of reference to a “destination” frame of reference.

• The Registered Dose Compositor Actor combines two or more, spatially-related dose instances to produce an output dose instance in the destination frame of reference.
• The Registered Compositing Planner Actor uses one or more dose instances as the basis (“prior dose”) for creating a new treatment plan and dose instances.

The DCOM Profile defines two dose viewer actors to permit display of single plan or composite doses without requiring an accompanying plan instance.

• The General Dose Viewer Actor retrieves and displays Modality Image(s), RT Structure Set, and a General Dose. It requires that dose, images, and structure set share the same frame of reference.
• The Registered General Dose Viewer Actor retrieves Modality Image(s), Registered RT Structure Set, General Dose, and Spatial Registration. It displays doses registered to the image/structure set frame of reference.

Dose objects accepted by the Registered Dose Compositor and Registered Compositing Planner Actors and displayed by the General Dose Viewer and Registered General Dose Viewer Actors are those stored by the Single Plan Dose Producer, Registered Dose Compositor, or Registered Compositing Planner Actors.

The diagram below shows transactions among these Actors: