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1. A generalized software framework for consolidation of radiotherapy planning and delivery data from diverse data sources

Author

Abdulkadir, Yasin, Hink, Justin, Boyle, Peter, Luximon, Dishane, Pijanowski, Justin, Ritter, Timothy, Curran, Bruce, Leu, Min, Nickols, Nicholas, Lee, Steve P., Palta, Jatinder R., Kelly, Maria, Kapoor, Rishabh, Thompson, Reid, Low, Daniel A., Lamb, James M., and Neylon, Jack

Subjects
Physics - Medical Physics
Abstract

Aggregating large-scale radiotherapy planning and delivery data is crucial for advancing radiation oncology research and improving clinical practice, yet challenges persist due to the diversity of treatment planning systems (TPS), record and verify (R&V) systems, and complex data formats lacking standardized retrieval methods. We developed a robust software framework that automates the collection and integration of multi-institutional radiotherapy data from diverse TPS and R&V systems. By utilizing the unidirectional references of DICOM objects, our framework reconstructs complete patient datasets starting from Radiotherapy Treatment Records (RTRECORDs), managing tasks such as data queries, transfers, verification, and logging. It effectively maps DICOM linkages between RTRECORDs, RTPLANs, RTDOSEs, RTSTRUCTs, planning images, registrations, and associated diagnostic images, incorporating custom modules for data conversion and comprehensive error handling. Implemented across multiple institutions using various systems$-$ including ARIA, Eclipse, MOSAIQ, RayStation, MIM, Pinnacle$-$ the framework successfully collected data from two clinics over an 11-year period, aggregating data from 6,022 patients and 13,871 treatment plans with a success rate of 99.76% and an average processing time of approximately 18 minutes per patient. Ongoing efforts are extending data collection to clinics lacking DICOM Query/Retrieve capabilities, demonstrating the framework's adaptability to various clinical environments. This efficient automation of comprehensive data collection overcomes significant technical barriers, facilitating the creation of large-scale datasets that can accelerate advancements in radiation oncology., Comment: 11 pages, 5 figures

Published
2024

2. Radiotherapy and theranostics: a Lancet Oncology Commission

Author

Abdel-Wahab, May, Giammarile, Francesco, Carrara, Mauro, Paez, Diana, Hricak, Hedvig, Ayati, Nayyereh, Li, Jing Jing, Mueller, Malina, Aggarwal, Ajay, Al-Ibraheem, Akram, Alkhatib, Sondos, Atun, Rifat, Bello, Abubakar, Berger, Daniel, Delgado Bolton, Roberto C, Buatti, John M, Burt, Graeme, Bjelac, Olivera Ciraj, Cordero-Mendez, Lisbeth, Dosanjh, Manjit, Eichler, Thomas, Fidarova, Elena, Gondhowiardjo, Soehartati, Gospodarowicz, Mary, Grover, Surbhi, Hande, Varsha, Harsdorf-Enderndorf, Ekaterina, Herrmann, Ken, Hofman, Michael S, Holmberg, Ola, Jaffray, David, Knoll, Peter, Kunikowska, Jolanta, Lewis, Jason S, Lievens, Yolande, Mikhail-Lette, Miriam, Ostwald, Dennis, Palta, Jatinder R, Peristeris, Platon, Rosa, Arthur A, Salem, Soha Ahmed, dos Santos, Marcos A, Sathekge, Mike M, Shrivastava, Shyam Kishore, Titovich, Egor, Urbain, Jean-Luc, Vanderpuye, Verna, Wahl, Richard L, Yu, Jennifer S, Zaghloul, Mohamed Saad, Zhu, Hongcheng, and Scott, Andrew M

Published
2024
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3. Leveraging Radiotherapy Data for Precision Oncology: Veterans Affairs Granular Radiotherapy Information Database.

Author

Katsoulakis, Evangelia, Madison, Cecelia J., Kapoor, Rishabh, Melson, Ryan A., Gao, Anthony, Bian, Jiantao, Hausler, Ryan M., Danilov, Peter N., Nickols, Nicholas G., Solanki, Abhishek A., Sleeman IV, William C., Palta, Jatinder R., DuVall, Scott L., Lynch, Julie A., Thompson, Reid F., and Kelly, Maria

Subjects
MEDICAL communication, DATABASES, DATA warehousing, DIGITAL communications, SCIENTIFIC discoveries
Abstract

PURPOSE: Despite the frequency with which patients with cancer receive radiotherapy, integrating radiation oncology data with other aspects of the clinical record remains challenging because of siloed and variable software systems, high data complexity, and inconsistent data encoding. Recognizing these challenges, the Veterans Affairs (VA) National Radiation Oncology Program (NROP) is developing Granular Radiotherapy Information Database (GRID), a platform and pipeline to combine radiotherapy data across the VA with the goal of both better understanding treatment patterns and outcomes and enhancing research and data analysis capabilities. METHODS: This study represents a proof-of-principle retrospective cohort analysis and review of select radiation treatment data from the VA Radiation Oncology Quality Surveillance Program (VAROQS) initiative. Key radiation oncology data elements were extracted from Digital Imaging and Communications in Medicine Radiotherapy extension (DICOM-RT) files and combined into a single database using custom scripts. These data were transferred to the VA's Corporate Data Warehouse (CDW) for integration and comparison with the VA Cancer Registry System and tumor sequencing data. RESULTS: The final cohort includes 1,568 patients, 766 of whom have corresponding DICOM-RT data. All cases were successfully linked to the CDW; 18.8% of VAROQS cases were not reported in the existing VA cancer registry. The VAROQS data contributed accurate radiation treatment details that were often erroneous or missing from the cancer registry record. Tumor sequencing data were available for approximately 5% of VAROQS cases. Finally, we describe a clinical dosimetric analysis leveraging GRID. CONCLUSION: NROP's GRID initiative aims to integrate VA radiotherapy data with other clinical data sets. It is anticipated to generate the single largest collection of radiation oncology–centric data merged with detailed clinical and genomic data, primed for large-scale quality assurance, research reuse, and discovery science. [ABSTRACT FROM AUTHOR]

Published
2025
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4. The report of Task Group 100 of the AAPM: Application of risk analysis methods to radiation therapy quality management

Author

Huq, M Saiful, Fraass, Benedick A, Dunscombe, Peter B, Gibbons, John P, Ibbott, Geoffrey S, Mundt, Arno J, Mutic, Sasa, Palta, Jatinder R, Rath, Frank, Thomadsen, Bruce R, Williamson, Jeffrey F, and Yorke, Ellen D

Subjects
Medical and Biological Physics, Physical Sciences, Cancer, Patient Safety, Humans, Medical Errors, Neoplasms, Quality Assurance, Health Care, Radiotherapy Planning, Computer-Assisted, Radiotherapy, Intensity-Modulated, Risk Assessment, process mapping, FMEA, FTA, risk-based-QM program, Other Physical Sciences, Biomedical Engineering, Oncology and Carcinogenesis, Nuclear Medicine & Medical Imaging, Biomedical engineering, Medical and biological physics
Abstract

The increasing complexity of modern radiation therapy planning and delivery challenges traditional prescriptive quality management (QM) methods, such as many of those included in guidelines published by organizations such as the AAPM, ASTRO, ACR, ESTRO, and IAEA. These prescriptive guidelines have traditionally focused on monitoring all aspects of the functional performance of radiotherapy (RT) equipment by comparing parameters against tolerances set at strict but achievable values. Many errors that occur in radiation oncology are not due to failures in devices and software; rather they are failures in workflow and process. A systematic understanding of the likelihood and clinical impact of possible failures throughout a course of radiotherapy is needed to direct limit QM resources efficiently to produce maximum safety and quality of patient care. Task Group 100 of the AAPM has taken a broad view of these issues and has developed a framework for designing QM activities, based on estimates of the probability of identified failures and their clinical outcome through the RT planning and delivery process. The Task Group has chosen a specific radiotherapy process required for "intensity modulated radiation therapy (IMRT)" as a case study. The goal of this work is to apply modern risk-based analysis techniques to this complex RT process in order to demonstrate to the RT community that such techniques may help identify more effective and efficient ways to enhance the safety and quality of our treatment processes. The task group generated by consensus an example quality management program strategy for the IMRT process performed at the institution of one of the authors. This report describes the methodology and nomenclature developed, presents the process maps, FMEAs, fault trees, and QM programs developed, and makes suggestions on how this information could be used in the clinic. The development and implementation of risk-assessment techniques will make radiation therapy safer and more efficient.

Published
2016

6. Radiotherapy Planning and Peer Review in Sub-Saharan Africa: A Needs Assessment and Feasibility Study of Cloud-Based Technology to Enable Remote Peer Review and Training

Author

Lewis, Philippa J., Amankwaa-Frempong, Emmanuel, Makwani, Hellen, Nsingo, Memory, Addison, Eric C. D. K., Acquah, George F., Yusufu, Shaid, Makufa, Remigio, Edusa, Clement E., Dharsee, Nazima J., Grover, Surbhi, Court, Laurence E., Palta, Jatinder R., Kapoor, Rishabh, and Aggarwal, Ajay

Published
2021
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8. Head and Neck Cancer

Author

Mendenhall, William M., Amdur, Robert J., Palta, Jatinder R., Brady, L. W., editor, Heilmann, H. -P., editor, Molls, M., editor, Perez, Carlos A., Vijayakumar, Srinivasan, Levitt, Seymour H., editor, and Purdy, James A., editor

Published
2006
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26. VA-Radiation Oncology Quality Surveillance Program

Author

Hagan, Michael, primary, Kapoor, Rishabh, additional, Michalski, Jeff, additional, Sandler, Howard, additional, Movsas, Benjamin, additional, Chetty, Indrin, additional, Lally, Brian, additional, Rengan, Ramesh, additional, Robinson, Cliff, additional, Rimner, Andreas, additional, Simone, Charles, additional, Timmerman, Robert, additional, Zelefsky, Michael, additional, DeMarco, John, additional, Hamstra, Daniel, additional, Lawton, Colleen, additional, Potters, Louis, additional, Valicenti, Richard, additional, Mutic, Sasa, additional, Bosch, Walter, additional, Abraham, Christopher, additional, Caruthers, Douglas, additional, Brame, Ryan, additional, Palta, Jatinder R., additional, Sleeman, William, additional, and Nalluri, Joseph, additional

Published
2020
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27. AAPM medical physics practice guideline 7.a.: Supervision of medical physicist assistants

Author

Seibert, J. Anthony, primary, Blatnica, Anthony P., additional, Clements, Jessica B., additional, Halvorsen, Per H., additional, Herman, Michael G., additional, Johnson, Jennifer L., additional, Schueler, Beth A., additional, Martin, Melissa C., additional, Palta, Jatinder R., additional, Pfeiffer, Douglas E., additional, Pizzutiello, Robert J., additional, Prisciandaro, Joann I., additional, and Sherouse, George W., additional

Published
2019
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28. AAPM medical physics practice guideline 7.a.: Supervision of medical physicist assistants.

Author

Seibert, J. Anthony, Blatnica, Anthony P., Clements, Jessica B., Halvorsen, Per H., Herman, Michael G., Johnson, Jennifer L., Schueler, Beth A., Martin, Melissa C., Palta, Jatinder R., Pfeiffer, Douglas E., Pizzutiello, Robert J., Prisciandaro, Joann I., and Sherouse, George W.

Subjects
MEDICAL physics, MEDICAL assistants, MEDICAL practice, MEDICAL sciences, QUALITY of service
Abstract

The American Association of Physicists in Medicine (AAPM) is a nonprofit professional society whose primary purposes are to advance the science, education and professional practice of medical physics. The AAPM has more than 8,000 members and is the principal organization of medical physicists in the United States. The AAPM will periodically define new practice guidelines for medical physics practice to help advance the science of medical physics and to improve the quality of service to patients throughout the United States. Existing medical physics practice guidelines will be reviewed for the purpose of revision or renewal, as appropriate, on their fifth anniversary or sooner. Each medical physics practice guideline represents a policy statement by the AAPM, has undergone a thorough consensus process in which it has been subjected to extensive review, and requires the approval of the Professional Council. The medical physics practice guidelines recognize that the safe and effective use of diagnostic and therapeutic radiology requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guidelines and technical standards by those entities not providing these services is not authorized. The following terms are used in the AAPM practice guidelines: Must and Must Not: Used to indicate that adherence to the recommendation is considered necessary to conform to this practice guideline.Should and Should Not: Used to indicate a prudent practice to which exceptions may occasionally be made in appropriate circumstances. Approved by AAPM's Executive Committee May 28, 2019 [ABSTRACT FROM AUTHOR]

Published
2020
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30. Quality Assurance for Clinical Trials: A Primer for Physicists

Author

Olch, Arthur J., primary, Kline, Robert W., additional, Ibbott, Geoffrey S., additional, Anderson, James R., additional, Deye, James, additional, FitzGerald, T. J., additional, Followill, David, additional, Gillin, Michael T., additional, Huq, M. Saiful, additional, Palta, Jatinder R., additional, Purdy, James A., additional, and Urie, Marcia M., additional

Published
2004
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31. Fetal Dose from Radiotherapy with Photon Beams

Author

Stovall, Marilyn, primary, Blackwell, Charles Robert, additional, Cundiff, Jackson, additional, Novack, Devorah H., additional, Palta, Jatinder R., additional, Wagner, Louis K., additional, Webster, Edward W., additional, and Shalek, Robert J., additional

Published
1995
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32. Comprehensive QA for Radiation Oncology

Author

Kutcher, Gerald J., primary, Coia, Lawrence, additional, Gillin, Michael, additional, Hanson, William F., additional, Leibel, Steven, additional, Morton, Robert J., additional, Palta, Jatinder R., additional, Purdy, James A., additional, Reinstein, Lawrence E., additional, Svensson, Goran K., additional, Weller, Mona, additional, and Wingfield, Linda, additional

Published
1994
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33. Monitor unit calculations for external photon and electron beams: Report of the AAPM Therapy Physics Committee Task Group No. 71

Author

Gibbons, John P., Antolak, John A., Followill, David S., Huq, M. Saiful, Klein, Eric E., Lam, Kwok L., Palta, Jatinder R., Roback, Donald M., Reid, Mark, and Khan, Faiz M.

Subjects
Photons, Phantoms, Imaging, Radiotherapy Planning, Computer-Assisted, Humans, Electrons, Radiotherapy, Intensity-Modulated, Radiation Dosage, Radiometry, Monte Carlo Method, Algorithms, TASK GROUP REPORT (Online only)
Abstract

A protocol is presented for the calculation of monitor units (MU) for photon and electron beams, delivered with and without beam modifiers, for constant source-surface distance (SSD) and source-axis distance (SAD) setups. This protocol was written by Task Group 71 of the Therapy Physics Committee of the American Association of Physicists in Medicine (AAPM) and has been formally approved by the AAPM for clinical use. The protocol defines the nomenclature for the dosimetric quantities used in these calculations, along with instructions for their determination and measurement. Calculations are made using the dose per MU under normalization conditions, \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{upgreek} \usepackage{mathrsfs} \setlength{\oddsidemargin}{-69pt} \begin{document} }{}$D_0^\prime $\end{document}D0′, that is determined for each user's photon and electron beams. For electron beams, the depth of normalization is taken to be the depth of maximum dose along the central axis for the same field incident on a water phantom at the same SSD, where \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{upgreek} \usepackage{mathrsfs} \setlength{\oddsidemargin}{-69pt} \begin{document} }{}$D_0^\prime $\end{document}D0′ = 1 cGy/MU. For photon beams, this task group recommends that a normalization depth of 10 cm be selected, where an energy-dependent \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{upgreek} \usepackage{mathrsfs} \setlength{\oddsidemargin}{-69pt} \begin{document} }{}$D_0^\prime $\end{document}D0′ ≤ 1 cGy/MU is required. This recommendation differs from the more common approach of a normalization depth of dm, with \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{upgreek} \usepackage{mathrsfs} \setlength{\oddsidemargin}{-69pt} \begin{document} }{}$D_0^\prime $\end{document}D0′ = 1 cGy/MU, although both systems are acceptable within the current protocol. For photon beams, the formalism includes the use of blocked fields, physical or dynamic wedges, and (static) multileaf collimation. No formalism is provided for intensity modulated radiation therapy calculations, although some general considerations and a review of current calculation techniques are included. For electron beams, the formalism provides for calculations at the standard and extended SSDs using either an effective SSD or an air-gap correction factor. Example tables and problems are included to illustrate the basic concepts within the presented formalism.

Published
2014

36. International Outreach: What Is the Responsibility of ASTRO and the Major International Radiation Oncology Societies?

Author

Mayr, Nina A., primary, Hu, Kenneth S., additional, Liao, Zhongxing, additional, Viswanathan, Akila N., additional, Wall, Terry J., additional, Amendola, Beatriz E., additional, Calaguas, Miriam J., additional, Palta, Jatinder R., additional, Yue, Ning J., additional, Rengan, Ramesh, additional, and Williams, Timothy R., additional

Published
2014
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37. Report of AAPM Therapy Physics Committee Task Group 74 : In-air output ratio, Sc, for megavoltage photon beams

Author

Zhu, Timothy C., Ahnesjö, Anders, Lam, Kwok Leung, Li, X. Allen, Ma, Chang-Ming Charlie, Palta, Jatinder R., Sharpe, Michael B., Thomadsen, Bruce, Tailor, Ramesh C., Zhu, Timothy C., Ahnesjö, Anders, Lam, Kwok Leung, Li, X. Allen, Ma, Chang-Ming Charlie, Palta, Jatinder R., Sharpe, Michael B., Thomadsen, Bruce, and Tailor, Ramesh C.

Abstract

The concept of in-air output ratio (Sc) was introduced to characterize how the incident photon fluence per monitor unit (or unit time for a Co-60 unit) varies with collimator settings. However, there has been much confusion regarding the measurement technique to be used that has prevented the accurate and consistent determination of Sc. The main thrust of the report is to devise a theoretical and measurement formalism that ensures interinstitutional consistency of Sc. The in-air output ratio, Sc, is defined as the ratio of primary collision water kerma in free-space, Kp, per monitor unit between an arbitrary collimator setting and the reference collimator setting at the same location. Miniphantoms with sufficient lateral and longitudinal thicknesses to eliminate electron contamination and maintain transient electron equilibrium are recommended for the measurement of Sc. The authors present a correction formalism to extrapolate the correct Sc from the measured values using high-Z miniphantom. Miniphantoms made of high-Z material are used to measure Sc for small fields (e.g., IMRT or stereotactic radiosurgery). This report presents a review of the components of Sc, including headscatter, source-obscuring, and monitor-backscattering effects. A review of calculation methods (Monte Carlo and empirical) used to calculate Sc for arbitrary shaped fields is presented. The authors discussed the use of Sc in photon dose calculation algorithms, in particular, monitor unit calculation. Finally, a summary of Sc data (from RPC and other institutions) is included for QA purposes.

Published
2009
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39. Redesigning Radiotherapy Quality Assurance: Opportunities to Develop an Efficient, Evidence-Based System to Support Clinical Trials—Report of the National Cancer Institute Work Group on Radiotherapy Quality Assurance

Author

Bekelman, Justin E., primary, Deye, James A., additional, Vikram, Bhadrasain, additional, Bentzen, Soren M., additional, Bruner, Deborah, additional, Curran, Walter J., additional, Dignam, James, additional, Efstathiou, Jason A., additional, FitzGerald, T.J., additional, Hurkmans, Coen, additional, Ibbott, Geoffrey S., additional, Lee, J. Jack, additional, Merchant, Thomas E., additional, Michalski, Jeff, additional, Palta, Jatinder R., additional, Simon, Richard, additional, Ten Haken, Randal K., additional, Timmerman, Robert, additional, Tunis, Sean, additional, Coleman, C. Norman, additional, and Purdy, James, additional

Published
2012
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41. The American Society for Radiation Oncology’s 2010 Core Physics Curriculum for Radiation Oncology Residents

Author

Xiao, Ying, primary, De Amorim Bernstein, Karen, additional, Chetty, Indrin J., additional, Eifel, Patricia, additional, Hughes, Lesley, additional, Klein, Eric E., additional, McDermott, Patrick, additional, Prisciandaro, Joann, additional, Paliwal, Bhudatt, additional, Price, Robert A., additional, Werner-Wasik, Maria, additional, and Palta, Jatinder R., additional

Published
2011
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46. IMRT commissioning: Multiple institution planning and dosimetry comparisons, a report from AAPM Task Group 119

Author

Ezzell, Gary A., primary, Burmeister, Jay W., additional, Dogan, Nesrin, additional, LoSasso, Thomas J., additional, Mechalakos, James G., additional, Mihailidis, Dimitris, additional, Molineu, Andrea, additional, Palta, Jatinder R., additional, Ramsey, Chester R., additional, Salter, Bill J., additional, Shi, Jie, additional, Xia, Ping, additional, Yue, Ning J., additional, and Xiao, Ying, additional

Published
2009
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49. Third-party brachytherapy source calibrations and physicist responsibilities: Report of the AAPM Low Energy Brachytherapy Source Calibration Working Group

Author

Butler, Wayne M., primary, Bice, William S., additional, DeWerd, Larry A., additional, Hevezi, James M., additional, Huq, M. Saiful, additional, Ibbott, Geoffrey S., additional, Palta, Jatinder R., additional, Rivard, Mark J., additional, Seuntjens, Jan P., additional, and Thomadsen, Bruce R., additional

Published
2008
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