AAPM Plan Challenge: SBRT Lung

Posted on

The success and interest level in the “Plan Challenge” has now permeated to the AAPM, where we will be integrating a AAPM-dedicated Plan Challenge into a 2-hour special session on Plan Quality at the 2014 Spring Clinical Meeting.

In this Plan Challenge, we offer our first hypofractionated lung case. Participation is encouraged from physicists and dosimetrists alike, both domestic and international. Results will be presented for the first time on March 15, 2015 in Denver, CO, but we will repeat the results via live webinars and/or videos posted online after the AAPM spring meeting.

Here are some key links regarding the 2014 AAPM Plan Challenge:

– Link to register (which will kick off the ROR portal that will steer you through the process)
– Link to a recorded meeting going over the anatomy, objectives, and other interesting discussions on the particular Plan Quality Algorithm to be used
– For Quality Reports users, here is a link to a downloadable protocol which you can import directly into Quality Reports 1.1 or later, to allow self-scoring. Use the protocol labeled “AAPM Plan Challenge.”

Spread the word!...

New QA Publication is “Most Read” Article in Medical Physics 40(11), November 2013

Posted on

Thanks to my colleagues and co-authors, our newest publication was deemed “Editor’s Pick” for the November issue of the Medical  Physics journal.

The paper is called “Evaluating IMRT and VMAT dose accuracy: Practical examples of failure to detect systematic errors when applying a commonly used metric and action levels” and can be found in Medical Physics, volume 40(11) which was published in November of 2013.

You can link to the abstract and download the paper here....

Quality Reports [EMR]® 1.1 Released

Posted on

Thanks to all the users and research partners who provided great input and validation of the many enhancements in this new version. Quality Reports now makes it even easier and to produce customized and comprehensive documentation of radiation plan quality, and further improves the automation of protocol analysis for meaningful use EMR.

The full release summary of changes and new installers are now available for download via the secure downloads portal (see the “Download” link in the banner).

QR1.1releaseImage_600x300...

New Publication: Interplay of Target Motion and Dynamic VMAT Delivery for SBRT

Posted on

Together with Moffitt Cancer Center (Tampa, FL) and the team of Vladimir Feygelman, Ph.D., we continue our ongoing scientific studies with a new publication called “Experimentally studied dynamic dose interplay does not meaningfully affect target dose in VMAT SBRT lung treatments,” just published in Medical Physics 40(9). We are proud to say this paper was selected as one of the “Editor’s Picks” for this issue (which, among other things, means anybody can download the PDF of the article for free – a really nice feature offered by the Medical Physics journal).

Prior to this work, we had been building up our knowledge and toolset for analyzed 4D doses, specifically for volume-modulated arc therapy (VMAT). We applied to clinical SBRT plans (hypo-fractionated with 10 Gy/fraction, 5 total fractions), and at first we were surprised by our results. Then, as we set about understanding the interplay phenomenon for hypo-fractionated VMAT, it started to make more and more intuitive sense why we didn’t see interplay effects. First, the high dose per fraction ultimately allows for many cycles of breathing motion during each daily delivery, which tends to average out the interplay effect. Second, the VMAT segments tend to be less complex at any given time than dynamic IMRT segments (which we know are susceptible to interplay, at least per fraction), also working to drive down interplay. And finally, a strategy of optimization of our VMAT plans was to pump up the dose at the PTV periphery, i.e. purposely induce dose heterogeneity, and the benefits of this for a moving target are evidence in this paper....

New Publication: Bio-Models to Assess Plan Robustness / Dose QA

Posted on

It has my pleasure to work with my colleagues Wolfgang Tomé and Heming Zhen on a multi-phased study on the methods and metrics of patient-specific Dose QA.

Recently, we published our third paper on this topic called “On the use of biomathematical models in patient-specific IMRT dose QA,” which was published in Medical Physics 40(7). This paper looked at how to use biological model-based DVH reduction methods to analyze dose changes observed during per-patient dose QA, but more importantly raised the idea of using bio-models to assess the “robustness” of highly conformal plans (IMRT and VMAT). That is, wouldn’t it be useful to quantify how susceptible these plans are (or would be) to TPS or delivery errors? Moreover, wouldn’t this make sense to do as part of optimizing the plan vs. after? It’s a common sense approach to quality....

Canis Lupus LLC Awards $100,000 Technology Grant to SIU Dosimetry Program

Posted on

In the past few years, I’ve developed closer collaborations with the dosimetry community, giving annual talks at the national AAMD meeting and working with Radiation Oncology Resources, Inc. to develop much-needed Quality Systems and training programs for radiation therapy. In the process, I have met more and more dosimetrists and dosimetry students, and am always impressed by their hunger to learn, improve, and share techniques and best practices. Dosimetrists are a highly collaborative population of colleagues as opposed to a competitive population of rivals. This is healthy.

As part of my commitment and appreciation for the dosimetry community, I proudly announce that I will be working with Dr. Scott Collins and his Dosimetry Master program at Southern Illinois University (Carbondale). I will be giving guest lectures, working with ROR to run plan quality projects (i.e. Plan Challenges devoted to the students), and most importantly I will be arming the students with “Quality Reports [EMR]” licenses throughout their education.

We just finished a pilot project with the outgoing class of 2013, and in just a few weeks we were already seeing how the software can help on so many fronts – from interactive education on core principles of radiation therapy, to clinical protocols and continual improvement initiatives. We now look forward to the 2014 class, and beyond.

– Ben Nelms...

ROR-US Oncology: Quality Reports Technology Integral to Landmark Agreement

Posted on

Great news! Today, the US Oncology Network (USON) and Radiation Oncology Resources (ROR) announced a landmark deal for a network-wide quality system to be integrated for the vast network of USON clinicians. This quality system will help ensure the highest quality of care and set new standards of evidence-based medicine. I am proud to say that Quality Reports [EMR] is the integral technology component to be used by ROR for benchmarking and quality improvement of radiation treatment plans.

Congratulations to both ROR and USON for your commitment to advancing quality of radiation therapy. Your wise decision and hard work will enhance the standard of care for a great many cancer patients.

Here are links to the full press release: From the “Daily Finance” website....

Quality Reports [EMR] Commercially Released

Posted on

Today, customized EMR for modern radiation therapy takes a giant leap forward with the commercial release of Quality Reports [EMR], version 1.0. The first wave of customers span the United States coast-to-coast, from North Carolina to Oregon. These new customers join an already strong base of clinical research partners who have been using the software for many months and who have submitted five related studies to annual professional meetings in North America (e.g. four submissions to ASTRO 2013).

Quality Reports [EMR]™ software, designed specifically for modern radiation therapy, generates advanced, customizable electronic reports for the patient EMR/EHR system. Quality Reports [EMR]: 1) works with all planning systems, R&V, and delivery modalities, interfacing via DICOM storage and archive; 2) automates protocols (or physician-specific goals) via quantitative, user-defined collections of critical plan metrics; and 3) creates/manages “histories” of plan quality, enabling continual improvement and ensuring meaningful use of the EMR....

Quality Reports [EMR] Begins Validation Phase

Posted on

Quality Reports [EMR] software will begin official validation testing on February 4, 2013. This is the final phase of testing this new, exciting product.

Thankfully, we have some great validation partners who have been using the software regularly for clinical EMR, powerful & automated protocols, plan quality assessment, and research. I would like to personally thank Goshen Hospital (Goshen, IN), Moffitt Cancer Center (Tampa, FL), and especially the great folks at L’Hôpital Rosemont-Maissoneuve (Montreal, Quebec) who have been giving excellent feedback for so many months. Merci Beaucoup, mes amis.

And last but not least, I thank my partners in this endeavor – the talented CMD’s at Radiation Oncology Resources: Greg, Kyle, Adam, Steve, and Sharath. We’ve come a long way fellas, but it’s only the beginning.

** Update: February 23rd ** Quality Reports [EMR] onsite validation is complete! Design transfer tests will be run using the “customer portal” for product and documentation downloads during the week of February 25th. User documentation and a special video training series will also be finishing up soon, wrapping up version 1.0 and allowing the official commercial release by ~March 8th....