Latest revision of the MMRO-III Profile (Trial Implementation, updated 7/17/19) is 1.12.

The MMRO-III profile defines the information required for image registration, contouring and display using multiple image series, and the display of the resultant dose calculation on the different image modalities. It requires that these systems support CT, PET, and MRI imaging as a minimum standard of performance. The MMRO-III profile updated the MMRO-II profile by relaxing the restrictions of a primary data set that is a CT, which means that image sets can be arbitrarily registered in any order. For details on the profile, visit the MMRO-III-page.

• The MMRO-III Profile is tested by transferring datasets through a sequence of Actors. Each producer Actor in this sequence is to be tested with three downstream consumers, and each consumer Actor is to be tested using data from three upstream producers.
• Several datasets are used to test various aspects of image registsration, contouring and display:
  • Datasets 2, 3, and 4 demonstrate handling of non-HFS patient scan positions.
  • Datasets 7 and 10 demonstrate handling of multiple imaging modalities (CT, MR, PET).
  • Dataset 7 demonstrates handling of hybrid (single frame of reference) datasets.
  • Dataset 10 demonstrates handling of non-hybrid (multiple frames of reference) datasets.
• Testing guidelines
  1. Each Actor must demonstrate at least one registration involving mulitple modalities and a non-CT primary (using patient #10) with each test partner.
  2. Each Actor must be able to correctly handle images acquired in non-axial (e.g., Sagittal MR) image planes.
  3. Each Actor must demonstrate successful exchange of datasets 2, 3, 4 with at least one upstream and one downstream test partner. Be prepared to demonstrate any of these datasets with each peer, (at the judge's request).
  4. Each Actor must demonstrate correct handling of hybrid (shared FoR) and non-hybrid (separate FoR) datasets.

vv = Vendor code for the Registrator Actor

Note: Dataset #10 includes a Sagittal MR series. Import and display of Sagittal image series is required to pass testing of the MMRO-III Profile.

Preparation

1. Import images from patient 2,3,4,7,10

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

1. Register all image Series. Note that the Registered (“Primary”) Frame of Reference should be that of a non-CT image Series for at least one test case (i.e., for patient 10).
2. Export the DICOM Spatial Registration to the Archive.
3. Create a second rigid registration with a known (noted) offset and export this Spatial Registration to the Archive. (Indicate the offset in the Series Description of the Spatial Registration.)
4. Optional: If possible, also create one contour on the primary image set to aid the Registered Display Actor, and save the RT Structure Set to the Archive.

Then for each peer (Registered Display, Registered Contourer):

1. Let Registered Display or Registered Contourer import images and registrations from the Registrator
2. Compare Registrator and Registered Display/Registered Contourer to verify that the registrations are consistent (also verify image orientation and patient orientation labels)

Preparation

1. Import images from patient 2,3,4,7,10
2. For each patient, use registration from registrator, contour on both primary and secondary images.
3. Contours must be saved in the FoR of the Primary (Note that this need not be CT Image).
4. Export contours to the Archive.
5. Please indicate the vendor of the Registered Contourer Actor in the Series Description of the RT Structure Set stored to the Archive.

Testing

For each Peer (Registered Contourer, Registered Display):

1. Tester imports images, registrations and contours from Peer's corresponding patient
2. Tester shows it can read in and apply the registration
3. Tester shows it can display contours on both images (using registration above)
4. Tester draws contours on one of the images
5. Tester moves contours onto other images (using imported registration)
6. Tester exports these contours (now in other FoR than drawn) to PACS
7. Peer imports images and contours and displays them correctly: name, shape, position, (color)

Preparation

1. Tester imports images, structure set, and SRO for patient 2,3,4,7,10

Testing For each peer do the following

1. Tester shows it can read in and apply the registration
2. Tester shows it can display contours on both image Series using imported SRO
3. Side-by-side comparison of Registered Display and Registered Contourer is used to verify interoperable transfer.
4. Demonstrate correct handling of “hybrid” (same FoR) case using patient 7 data.

Note that the creation of dose objects may not necessarily be done by a peer being tested for this profile, e.g. BRTO/BRTO-II Dosimetric Planner.

Preparation (Not actually a requirement for the vendor being tested to pass the profile, but encouraged if possible to create the test data needed for testing)

1. Use patient 2,3,4 or 10
2. Create registration between primary and secondary image
3. Create contours, plan & dose on primary images
4. Export registration, contours & dose to Archive
5. Demonstrate correct handling of “hybrid” (same FoR) case using patient 7 data.

Testing This is exactly the same as for Registered Display, but tester should also demonstrate the ability to correctly display dose on registered (i.e., secondary images) using SRO