Abstract
PurposeData errors caught late in treatment planning require time to correct, resulting in delays up to 1 week. In this work, we identify causes of data errors in treatment planning and develop a software tool that detects them early in the planning workflow.MethodsTwo categories of errors were studied: data transfer errors and TPS errors. Using root cause analysis, the causes of these errors were determined. This information was incorporated into a software tool which uses ODBC‐SQL service to access TPS's Postgres and Mosaiq MSSQL databases for our clinic. The tool then uses a read‐only FTP service to scan the TPS unix file system for errors. Detected errors are reviewed by a physicist. Once confirmed, clinicians are notified to correct the error and educated to prevent errors in the future. Time‐cost analysis was performed to estimate the time savings of implementing this software clinically.ResultsThe main errors identified were incorrect patient entry, missing image slice, and incorrect DICOM tag for data transfer errors and incorrect CT‐density table application, incorrect image as reference CT, and secondary image imported to incorrect patient for TPS errors. The software has been running automatically since 2015. In 2016, 84 errors were detected with the most frequent errors being incorrect patient entry (35), incorrect CT‐density table (17), and missing image slice (16). After clinical interventions to our planning workflow, the number of errors in 2017 decreased to 44. Time savings in 2016 with the software is estimated to be 795 h. This is attributed to catching errors early and eliminating the need to replan cases.ConclusionsNew QA software detects errors during planning, improving the accuracy and efficiency of the planning process. This important QA tool focused our efforts on the data communication processes in our planning workflow that need the most improvement.
Highlights
Physics pretreatment plan review has been shown to be one of the most effective ways to reduce errors in radiotherapy.[1]
We investigate the causes of various data errors that can occur during the treatment planning process and develop a software tool that can automatically detect them in advance
This conversion process is done using the MIM software platform for fusion and image registration (MIM software Inc., Cleveland, OH, USA). This converts the MRI to the planning CT imaging coordinate system, after which images can be imported into the treatment planning system
Summary
Physics pretreatment plan review has been shown to be one of the most effective ways to reduce errors in radiotherapy.[1] During this review, the physicist will independently evaluate the plan quality based on clinical goals, as well as verify that all of the technical details of the plan are correct. This process has become more challenging for the physicist to perform in the modern radiotherapy era for a number of reasons. This means that in order to complete a pretreatment physics review, the physicist must navigate through multiple electronic workspaces as well as check a significant number of parameters, often manually which can be quite complicated
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