Radiation Planning Assistant - A Web-based Tool to Support High-quality Radiotherapy in Clinics with Limited Resources
October 6th, 2023
This protocol describes a series of automated tools designed for high-quality radiotherapy autocontouring and autoplanning that are being packaged into a web-based service to maximize robustness and scalability while minimizing operational costs.
We have developed the Radiation Planning Assistant as a web-based tool intended to help low and middle-income countries scale their efforts to provide high-quality contouring and treatment planning for patients. Access to radiotherapy is very limited in most places in the world, and that's due to multiple factors, including shortage of staff and qualified radiation oncologists, therapy radiographers, and medical physicists, and what we hope for the RPA is to address some of these challenges. The Radiation Planning Assistant has been designed to provide high-quality contours and plans at minimal cost.
Our hope is to provide access to those tools for free for clinics who would not otherwise have access. Now that we have finished Version One of the Radiation Planning Assistant, we will start to develop the next versions. We will try to reduce the need for Manual upload and download of data and add new treatment sites and approaches.
Begin by launching the Radiation Planning Assistant or RPA. Then go to the Service Request dashboard on RPA interface by clicking the Service Request channel. Then click on the New Form to generate a new request form.
Complete the questions under the first section titled Demographics. Then select the Treatment Technique from the Treatment pull-down menu. Click on the Information icon in the Treatment Technique pull-down menu to access further details of the treatment technique.
Next, complete the questions in the second section titled Treatment General Questions. Now, move to Section 3 Titled Treatment Specific Questions, and complete the questions including the details of the treatment targets and prescription. Click on Submit to generate the Service Request PDF.
Select the patient in the patient list. Review the Service Request PDF, and click Accept to approve it. Next, go to the CT Scans dashboard by clicking on the CT Scans channel.
Select the option, Upload CT, and pick the folder where the CT Scan is stored using folder explorer. Follow the prompts to confirm the selection. Select the patient in the patient list to review the corresponding uploaded CT Scan.
Then load the entire 3D CT image by clicking on Load 3D. Now scroll between the slices in all views using Forward or Backward buttons located below the CT View to move to the next slice. Click the right Shift or left Shift buttons to move five slices in either direction.
Alternatively, move the cursor over any view and use the mouse to scroll between the slices. The Intersect button can also be clicked to overlay a crosshair on each CT view. Then click on any of the three views to move the crosshair causing the other views to follow accordingly.
Zoom into the image to further review it using the Zoom Pan button. Then right-click and hold down a CT view using the mouse to zoom. Click on Marked Iso to move the CT views to the marked Iso center.
To add a reference point, first, move the three views to the desired reference point location by using the Intersect tool. Next, click on the Ref Point button to add a reference point. To add a new reference point, clear the current point by clicking on Clear Ref Point.
Then add a new one. Accept the CT scan, then answer the questions below the CT images to minimize risk and reduce errors in the subsequent RPA calculations. Now click on Accept and follow the prompts.
To begin the monitoring process, first, review a completed RPA plan by selecting the patient and choosing Review at the top of the main dashboard. Download a completed RPA plan by clicking on the Download icon. When a new window opens the DICOM files along with the PDF version of the RPA Plan Report will be downloaded for import into the Treatment Planning System.
To upload the final plan to the website, select the patient and click Upload Plan. Choose the DICOM Structure file, Plan, and Dose files for upload. Finally, review the Plan Comparison Report by selecting the patient.
An example of a lateral field from a whole brain radiotherapy plan is shown here, while a lateral field from a bony landmark-based four-field box plan for cervical cancer is also shown. In both cases, the RPA created a final plan report. After downloading and importing the User's Treatment Planning System, the Service Request dashboard provides a quick status overview of the service request for current patients in the RPA.
Overview
The Radiation Planning Assistant (RPA) is a web-based tool designed to enhance radiotherapy contouring and treatment planning, particularly in low and middle-income countries. This protocol outlines the automated tools integrated into the RPA to ensure high-quality service while minimizing costs.
Key Study Components
Area of Science
- Radiotherapy
- Medical Physics
- Healthcare Technology
Background
- Access to radiotherapy is limited in many regions due to a shortage of qualified professionals.
- The RPA aims to address these challenges by providing accessible tools for clinics.
- Version One of the RPA has been completed, with plans for future enhancements.
- The tool is designed to facilitate high-quality treatment planning at minimal costs.
Purpose of Study
- To provide a scalable solution for radiotherapy planning in underserved areas.
- To improve the quality of patient care through automated contouring and planning.
- To reduce operational costs associated with radiotherapy services.
Methods Used
- Web-based interface for service requests and patient management.
- Automated tools for contouring and treatment planning.
- Step-by-step guidance for users to complete treatment requests.
- Integration of CT scan uploads and 3D imaging for treatment planning.
Main Results
- Successful generation of service request PDFs for treatment planning.
- Implementation of a user-friendly interface for managing patient data.
- Facilitation of CT scan uploads and 3D image analysis.
- Creation of comprehensive plan reports for treatment comparison.
Conclusions
- The RPA provides a vital resource for clinics lacking access to advanced radiotherapy tools.
- Future versions will aim to further streamline the process and expand treatment options.
- Continued development will enhance the tool's functionality and user experience.
Frequently Asked Questions
Executive Industry Relevance
Automated radiotherapy planning tools like the Radiation Planning Assistant (RPA) address critical workforce and infrastructure gaps in global oncology care. By standardizing contouring and treatment planning, RPA enables scalable, high-quality radiotherapy delivery in resource-limited settings. This capability supports enterprise-level efforts to expand access while maintaining clinical rigor and operational efficiency.
Strategic Applications in Biopharma R&D
Early Discovery & Target Validation
- Enables systematic evaluation of radiotherapy protocols across diverse patient datasets.
- Supports biological de-risking by standardizing contouring and planning outputs.
- Facilitates predictive confidence in treatment planning for translational research.
Screening & Assay Development
- Prepares validated imaging and planning datasets for downstream comparative studies.
- Promotes reproducibility and quantitative assessment of radiotherapy parameters.
- Enables scalable evaluation of new radiotherapy techniques or adjunct therapies.
Translational & Preclinical Research
- Aligns radiotherapy planning with disease-relevant imaging and anatomical models.
- Supports continuity from protocol development to preclinical validation of radiotherapy strategies.
- Provides a platform for risk-adjusted advancement of novel radiotherapy approaches.
Pipeline & Workflow Integration
The RPA integrates into the radiotherapy planning continuum, from initial imaging and protocol specification to plan generation and local system validation.
- Discovery Biology: Standardizes hypothesis testing for radiotherapy target delineation and dose planning.
- Screening: Delivers reproducible, quantitative planning outputs for comparative analysis.
- Analytics: Generates structured reports and DICOM datasets for cross-condition evaluation.
- Translational Research: Bridges protocol development with preclinical and clinical implementation in diverse settings.
- Enterprise Reuse: Provides a scalable, web-based planning capability adaptable across institutions and geographies.
Operational & Enterprise Impact
- Scientific Value: Increases predictive confidence and reduces variability in radiotherapy planning.
- Operational Value: Streamlines workflows, minimizes manual intervention, and enhances reproducibility.
- Strategic Value: Supports broader patient access and efficient resource allocation in oncology care.
- Portfolio Impact: Enables risk-adjusted prioritization of radiotherapy protocols and technology investments.
Implementation Considerations
- Requires expertise in radiotherapy protocol specification and imaging interpretation.
- Needs reliable internet access and integration with local treatment planning systems.
- Demands cross-team standardization for data entry and plan validation.
- Adaptation may be needed for different anatomical sites and treatment techniques.
- Manual data handling may persist until future automation enhancements are deployed.
