Room: AAPM ePoster Library
Purpose: Surface imaging using the VisionRT AlignRT system has been widely used in surface-guided radiotherapy (SGRT) for patient setup and motion monitoring for frameless intracranial stereotactic radiosurgery (SRS) and breast deep-inspiration breath-hold (DIBH) radiotherapy. When AlignRT signal is used for automatic beam holding via a motion management interface to a linear accelerator, the AlignRT online workstation is occupied during treatment hours, leaving no time to prepare patient data (PData) for future treatment. We have demonstrated how the problem can be alleviated in a busy clinic by developing a Dispatcher program using AlignRT offline workstations to prepare, verify and dispatch the PData to online treatment workstations.
Methods: The Dispatcher program was developed using 4 offline workstations to validate and dispatch the PData to any of 22 online workstations at 8 clinical centers. After the PData was prepared on an offline workstation using the AlignRT application, it was dispatched to assigned treatment workstations. The Dispatcher program performs a quality assurance check on PData before dispatch, rejecting invalid PData, including unapproved plans or having an incorrect number of reference surfaces. It handles various clinical scenarios, including multi-site treatments, multi-machine treatments, as well as concurrent or existing treatments. Isocenter coordinates, surface labels, and couch angles are logged for plan checking. The dispatcher also records dispatch history and creates backup copies in the event of conflicts.
Results: The Dispatcher program and remote preparation workflow have been successfully implemented in our institution for 9 months. Four revisions have been made to meet clinical needs, including automatic QA. More than 2000 cases have been checked and dispatched on offline workstations for SGRT, including cranial SRS and breast DIBH treatments.
Conclusion: We have implemented a new clinical workflow using the Dispatcher program on AlignRT offline workstations to facilitate surface-guided radiotherapy. It is recommended for a busy multi-center clinic.