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Session: Therapy: External Beam: Segmentation, Dose Calculation and Treatment Planning [Return to Session]

Improving Workflow Efficiency and Safety for RefleXion X1 Treatment Planning Process Via Eclipse API Scripting

E Simiele*, N Kovalchuk, Stanford University Cancer Center, Palo Alto, CA


MO-IePD-TRACK 6-5 (Monday, 7/26/2021) 3:00 PM - 3:30 PM [Eastern Time (GMT-4)]

Purpose: The RefleXionᵀᴹ X1 system is the first biology-guided radiotherapy machine that can target cancer in real-time using on-board PET imaging in combination with a 6MV FFF beam. The current version of the system is not yet integrated with any record and verify system, has limited contouring, dose evaluation, and isocenter placement tools. To improve efficiency and safety of the treatment planning process, application programming interface (API) scripting was utilized to overcome these limitations.

Methods: Eclipse, the primary treatment planning system (TPS) at our institution, is used to perform all contouring and plan dose evaluation for the RefleXion treatment plans. Therefore, two scripts were developed using the Eclipse API scripting framework. The first script, RefleXion Assistant, focuses on preparing structure sets for import and planning in the RefleXion TPS. Such preparation includes checking all structures are within the body contour, inserting a special couch contour, and verifying the proposed isocenter placement in outside the collision zone. The second script, Automated Plan Check (APC), generates the shift note and focuses on physics plan checks and plan quality evaluation of the treatment plans.

Results: RefleXion Assistant can check several planning failure-modes in the RefleXion TPS within 30sec, e.g., if a structure is outside the body, the RefleXion TPS will throw an error preventing optimization and requiring the planner to identify the offending structure, fix it, export/import the new structure, and adjust the plan setup. Example items checked with the APC include high-severity failure-modes, i.e., physician’s prescription dose/fractionation in Aria match the RefleXion plan, shift note accuracy, cardiac device policy compliance, etc. Plan quality is evaluated by computing DVH metrics and comparing them to institutional/clinical trials planning constraints.

Conclusion: Two API scripts were developed and implemented to prevent failure-modes with the RefleXion TPS, resulting in significant improvements in planning efficiency and safety.



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