Neumann DICOM RT Erweiterung

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Neumann DICOM RT Erweiterung Powered By Docstoc
					Die DICOM RT
Erweiterung –
Status 2007
Michael Neumann
Universität Würzburg
 Milestones
        1992 – IEC SC 62C
        1994 – Ad-hoc Working Group @ NEMA
        1997 – Plan, RT-Image, Dose,
               Structure Set
        1999 – Treatment Record
        2006 – RT Ion Extensions
        2006 – Informal Connectathon IHE-RO
        2007 – Workflow Extensions
               Formal Connectathon IHE-RO
41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann   07. Mai 2007   - 2
 1995 – DGMP Annual Meeting




41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann   07. Mai 2007   - 3
 1997 – DGMP AK1




41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann   07. Mai 2007   - 4
 WG7 Meetings
                                             30




                                                                                                                                                                              Supp 102
                                                                                          Supp 11

                                                                                                          Supp 29
                                             25
               Number of Participants




                                             20


                                             15


                                             10


                                                5
                                                                                           Workflow                                            Ion Subgroup
                                                0                                        Ion Therapy




                                                                                                                                                                    05
                                                          94




                                                                                                98




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41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann                                                                                                    07. Mai 2007   - 5
 RT Extensions to DICOM
        Change Proposals
                 54 submitted and released
                 17 in progress / preparation
        Supplements
                 Supp 11 (1997)                                          Radiotherapy Information
                                                                         Objects
                 Supp 29 (1999)                                          Radiotherapy Treatment
                                                                         Record and Media Extensions
                 Supp 102 (2006)                                         Radiotherapy Extensions for
                                                                         Ion Therapy

41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann   07. Mai 2007   - 6
 Change Proposals




                                                 … some examples




41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann   07. Mai 2007   - 7
 RT Plan – External
        Controlpoint interpretation
        Fractionation Scheme
        Frame of Reference UID
        Dose Reference UID
        Verification plans
        Setup beams
        Pitch and Roll Angle for table
                 IEC 62C/418/CDV – IEC 61217 A2
41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann   07. Mai 2007   - 8
 RT Plan – Brachy
        Source encapsulation
        Source Strength (Beta emmitters)
        Anisotropic sources

        Image reconstruction methods




41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann   07. Mai 2007   - 9
 RT Image
        Wire positions
        Fluence maps for beams



        RT Image Orientation
        Pixel Intensity (Fluroscopy / Film)



41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann   07. Mai 2007 - 10
 RT Structure Set
        Inner / Outer contours
        (Keyholing)

        Bifurcated structures

        Image References
                 Referenced Study Sequence
                 Contour Sequence

41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann   07. Mai 2007 - 11
 RT Dose
        Natural DVH (Brachytherapy)
        Pixel Representation for Error Dose
        Inhomogeneity correction
        Grid Frame Offset Vector
        Control Point Dose




41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann   07. Mai 2007 - 12
 RT Treatment Record
        Interpretation
                 Delivered Meterset
                 Interrupted Treatment




        Override Sequence References
        Correction Parameter
41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann   07. Mai 2007 - 13
 RT Ion Plan
        Linear Stopping Power Ratio
        Control Point Usage clarification
        Variable Virtual Source Distance




                                                                                              Paganetti et al., Medical Physics 31 (2004)


41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann                                           07. Mai 2007 - 14
 News and Current Work
        Workflow Management
        Query/Retrieve for RT Objects
        Segmentation SOP Class
        Multidimensional Presentation State
        'Next Generation' RT Objects

        IHE – Radiation Oncology

41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann   07. Mai 2007 - 15
 Workflow Management



 This task of process management has not been addressed in the current draft due to the absence of a
 consistent process model for a radiotherapy department, especially in an international context. As a
 result, the radiotherapy information objects contain a large number of conditional and optional data
 elements. Essentially the objects are intended to be used as “containers” for related radiotherapy data,
 with data being added as the object flows through the department.




41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann   07. Mai 2007 - 16
 Workflow Management
        2000 – MWL Extensions RT Series
        2002 – Supplement 74
                 RT General Purpose Worklist Extensions and
                 Calculation Service Model
                         Worklist driven
                         Input data
                         Push Model
        2004 – GPWL
                 Supp 74 + Supp 96

41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann   07. Mai 2007 - 17
 Workflow Management
        2005 / 2006
                 Supplement 74
                         Utilization of Worklist in Radiotherapy Treatment
                         Delivery
                 Supplement 96
                         Unified Worklist and Procedure Step


        2006 / 2007
                 Supp 74 and Supp 96 out for public comment
41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann   07. Mai 2007 - 18
 Supplement 74
                       TMS                                                   TDS                    MPV

                                                                      Archive


        RT Beams Delivery Instruction IOD
        RT Conventional Machine Verification SC
        RT Ion Machine Verification SC

41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann         07. Mai 2007 - 19
 Supplement 74 (simplified)
                                                                                   Treatment
                                                                                                                       Treatment Delivery
                                                      Archive                     Management
                                                                                                                         System (TDS)
                                                                                  System (TMS)
                          User



                                                                                                       Query UPS



                                       ‘Select Procedure’ on TDS console (optional if only one procedure in list)


                                                                     Retrieve required Archive objects (C-MOVE)


                                                                                               Set UPS (IN PROGRESS)

                                                                                           Retrieve TMS objects (C-MOVE)


                                                       ‘Start Treatment Session’ on TDS console

                                                                                              Create UPS (IN PROGRESS) ‘Beam1’


                                                                                                                                            Verify


                                                                                                                                  DELIVER RADIATION
                                                                                                    Set UPS (COMPLETED)

                                                                Store Results (RT Treatment Rec and other result objects)

                                                                                                 Set UPS (COMPLETED)


                                                 Indicate ‘Treatment Session Completed’ on TDS console




41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann                                                     07. Mai 2007 - 20
 Supplement 74
        Use Cases
                 Treatment Delivery Normal Flow – Internal
                 Verification
                 Treatment Delivery Normal Flow – External
                 Verification
                 Treatment-Delivery with External Verification -
                 Override or Additional Info Required
                 Treatment-Delivery with External Verification
                 – Machine Adjustment Required

41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann   07. Mai 2007 - 21
 Supplement 74
        Plan level – A
                 Initialize (N-CREATE)
        Beam level – B
                 To be verified (N-SET)
                 Start (N-ACTION)
                 Verification result
                 (N-EVENT-REPORT)
                 Verification paramters
                 (N-GET)
        Plan level – A
                 Terminate
                 (N-DELETE)
41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann   07. Mai 2007 - 22
 Supplement 96
        Combines MWL and PPS into normalized object
        Continuously updated
        Reflects progress from scheduled to complete
        Main new features
                 'Push' model
                 Progress tracking
                 Lock for processing
                 Subscribe for notifications
                 Cancel task


41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann   07. Mai 2007 - 23
 Supplement 96




41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann   07. Mai 2007 - 24
 Supplement 96
        Create (schedule) new UPS
        Subscribe/Unsubscribe to event notifications
        Query for matching UPS
        Get contents of a UPS
        Lock control of in-progress UPS
        Set/report progress of a UPS
        Send state changes to UPS
        Cancel/Discontinue a UPS


41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann   07. Mai 2007 - 25
 Supplement 96
        Performing System queries worklist
        Scheduling system pushes workitem to
        performing system
        Performing system creates own workitem
        Performing system locks workitem
        Requesting system cancels workitem
        Watching system subscribes for reports


41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann   07. Mai 2007 - 26
 Query/Retrieve
        2000 – First discussions
        2003 – Q/R for RT Objects as IHE Profile
        2006 – Draft for Technical Framework




41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann   07. Mai 2007 - 27
 Segmentation
        Supplement 111 (2006):
        Segmentation Storage SOP Class
                 Any Modality
                 Segmentation Type
                         BINARY
                         FRACTIONAL (PROB, OCCU)
                 Purely spatial image relationship



41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann   07. Mai 2007 - 28
 Multidimensional Presentation
        ROI display
                 Color, opacity, cutplane
        Annotations
                 Geometric shapes, Polygonal surfaces, Text
        Plot types
                 line, bar, point




41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann   07. Mai 2007 - 29
 'Next Generation' RT Objects
        RT Plan
                 includes all phases and variations
                 includes fractions schemes and
                 corresponding beams
                 less dynamic (exception: RT Plan Reference)




41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann   07. Mai 2007 - 30
 'Next Generation' RT Objects
        Plan adaptations (ART)
        Combinations of RT Plans
        References from/to RT Plans
                 RT Image
                 RT Treatment Record
                 RT Dose
        RT Plan versioning


41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann   07. Mai 2007 - 31
 'Next Generation' RT Objects
                                                                          11                                       (normalized object)

                                                                                                        Unified Procedure Step
                                                                                  1                                                        1                                                         1       +output dose             *       +output reference images
                                                                                                                                         11                      1       +output plan




                                                                                                               1



                                                                                                                            1
   +planning instructions                       1




                                                                                                                   1
                                                                                                                                                               «metaclass»                   RT Enhanced Dose IOD                   «metaclass»
                                                                                                                                                              Dosimetric Plan                                                     Reference Image
            RT Planning Instruction IOD

                                        *
                                                                                                                                                                               RT Conventional Dosimetric Plan IOD                               RT Enhanced Image IOD
                                        1

                                                                                                                                                                               RT Ion Dosimetric Plan IOD                                        Enhanced CT IOD
                 Links to any input objects
                 as needed to specify
                 planning task                                                                                                                                                 RT Brachytherapy Dosimetric Plan IOD
                                                                                                                                 1       +desired prescription                                                                                         Etc


                                                                                                                         RT Prescription IOD
                                                                              -planning registrations
                 +planning images




             *                                                                                                                                 +targets & RARs       *                                   *     +input plan
                                    *
                                                                          *

                                                                                                                                                                         *                      1
                 «metaclass»                                            «metaclass»                                                                      «metaclass»                                  «metaclass»
                   Image                                                Registration                                                                    Segmentation                                Simulation Plan
                                                    *               1

                                                                                                                                                    1                                                            RT Conventional Simulation Plan IOD


                                                                                                                                                                                                                 RT Ion Simulation Plan IOD
                                            CT Image IOD                                                Spatial Registration IOD                                             Segmentation IOD

                                                                                                                                                                                                                 RT Brachytherapy Simulation Plan IOD



                                            Enhanced CT Image IOD
                                                                                                         Deformable Spatial Registration IOD                                 Mesh-based Segmentation IOD (proposed)




                                            MR Image IOD




                                                Etc.




41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann                                                                                                                                                              07. Mai 2007 - 32
 'Next Generation' RT Objects
        Registration for planning
        Segmentation
        Beam placement
        Treatment planning
        Dose computation
        Patient positioning
        Treatment delivery
        Replanning (adaptive planning)
        Plan review
        Delivery review
41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann   07. Mai 2007 - 33
 www.ihe.net




41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann   07. Mai 2007 - 34
 IHE – RO Structure

        Planning Committee (PC)
                 High level planning                                                                IHE Connectathon 2006




                 Generate input (use cases) for TC


        Technical Committee (TC)
                 Elaborate on PC's use cases
                 Turn them into technical specifications
                 Generate input for development teams
41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann   07. Mai 2007 - 35
 IHE – RO Technical Framework
        The itegration profile for 2006 involves the
        flow of DICOM images and treatment
        planning data, from CT scan through dose
        display, for 3D conformal, external beam
        radiation therapy. The emphasis for this
        first Integration Profile is on reducing
        ambiguity and facilitating basic
        interoperability in the exchange of DICOM
        RT objects.
41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann   07. Mai 2007 - 36
 IHE – RO Technical Framework
        Integration Profiles and Actors - 2006
                                                                                                                     Acquisition Modality
                                                              Image Store (as specified by IHE Radiology Profile)
                                                                                                                        (CT Scanner)




                                                                  Single/Contoured Series Image Retrieval [RO-1]
                                                                              Multi-Series Image Retrieval [RO-6]
                                                                                    Structure Set Retrieval [RO-7]
                                                                                                                          Contourer
                                                              Resampled/Combined CT Series Storage [RO-11]
                                                              Structure Set Storage [RO-2]


                                        Archive


                                                                  Single/Contoured Series Image Retrieval [RO-1]
                                                                                   Structure Set Retrieval [RO-7]
                                                                                                                     Geometric Planner
                                                              Geometric Plan Storage [RO-3]




                                                                  Single/Contoured Series Image Retrieval [RO-1]
                                                                                   Structure Set Retrieval [RO-7]
                                                                                 Geometric Plan Retrieval [RO-8]
                                                                                                                     Dosimetric Planner
                                                              Dosimetric Plan Storage [RO-4]
                                                              Dose Storage [RO-5]




                                                                  Single/Contoured Series Image Retrieval [RO-1]
                                                                                   Structure Set Retrieval [RO-7]
                                                                                      Dosimetric Retrieval [RO-9]
                                                                                          Dose Retrieval [RO-10]
                                                                                                                       Dose Displayer



41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann                                           07. Mai 2007 - 37
 IHE – RO Technical Framework
        RO-1: Single/Contoured                                                                 RO-7: Structure Set
        Image Series Retrieval                                                                 Retrieval
        RO-2: Structure Set                                                                    RO-8: Geometric Plan
        Storage                                                                                Retrieve
        RO-3: Geometric Plan                                                                   RO-9: Dosimetric Plan
        Storage                                                                                Retrieve
        RO-4: Dosimetric Plan                                                                  RO-10: Dose Retrieve
        Storage                                                                                RO-11:
        RO-5: Dose Storage                                                                     Resampled/Combined CT
        RO-6: Multi-Series Image                                                               Series Storage
        Retrieve

41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann              07. Mai 2007 - 38
 IHE – RO Technical Framework
        Integration Profiles and Actors - 2007
                                                                     Worklist Query, Positioning [RO-12]
                                                                        Worklist Query, Delivery [RO-13]
                                                         Worklist Query, Positioning and Delivery [RO-14]     Treatment
                                                       Retrieve Workitem Input Objects from TMS [RO-17]
                                                              UWPS Procedure Step in Progress [RO-16]
                                                                                                              Management
                                                                      UWPS Positioning Update [RO-18]           System
                                                                         UWPS Delivery Update [RO-19]
                                                       UWPS Procedure Step Completed/Canceled [RO-22]
                      Archive
                                                           UWPS Procedure Step in Progress [RO-16]
                                                                   UWPS Positioning Update [RO-18]
                                                           Store Positioning Result to Archive [RO-20]         Patient
                                                     UWPS Procedure Step Completed/Canceled [RO-22]
                                                                       Worklist Query, Positioning [RO-12]
                                                                                                              Positioning
                                                      Retrieve Workitem Input Objects from Archive [RO-15]      Device
                                                        Retrieve Workitem Input Objects from TMS [RO-17]

                                                             UWPS Procedure Step in Progress [RO-16]
                                                                      UWPS Positioning Update [RO-18]
                                                                         UWPS Delivery Update [RO-19]
                                                              Store Positioning Result to Archive [RO-20]
                                                                Store Delivery Result to Archive [RO-21]     Treatment
                                                     UWPS Procedure Step Completed/Canceled [RO-22]
                                                                           Worklist Query, Delivery [RO-13]
                                                                                                               Delivery
                                                           Worklist Query, Positioning and Delivery [RO-14]    System
                                                     Retrieve Workitem Input Objects from Archive [RO-15]
                                                       Retrieve Workitem Input Objects from TMS [RO-17]




41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann                           07. Mai 2007 - 39
 IHE – RO Technical Framework
        RO-12: Worklist Query,                                                                 RO-17: Retrieve
        Positioning                                                                            Workitem Input Objects
        RO-13: Worklist Query,                                                                 from TMS
        Delivery                                                                               RO-18: UWPS
        RO-14: Worklist Query,                                                                 Positioning Update
        Positioning and Delivery                                                               RO-19: UWPS Delivery
        RO-15: Retrieve                                                                        Update
        Workitem Input Objects                                                                 RO-20: Positioning Result
        from Archive                                                                           Storage
        RO-16: UWPS in                                                                         RO-21: Delivery Result
        Progress                                                                               Storage
                                                                                               RO-22: UWPS Procedure
                                                                                               Step
                                                                                               Completed/Canceled

41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann                 07. Mai 2007 - 40
 TC – Main topics discussed
        Query/Retrieve Model for RT
        Support for Unified Worklist
        RT Dose load and display
        Multi-modality images and contours
        Accumulating Dose
        Dose optimization
        Image review (online / offline)
        Configuration Management
41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann   07. Mai 2007 - 41
 NEMA – Medical Division
        MITA
                 Medical Imaging & Technology Alliance




                        http://medicalimaging.org

41. Treffen AK Computer in der Radioonkologie - Freiburg | DICOM RT Status 2007 - Michael Neumann   07. Mai 2007 - 42
Die DICOM RT
Erweiterung –
Status 2007
Michael Neumann
Universität Würzburg

				
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