A review of digital image networking technologies for radiation oncology treatment planning

A web-based remote radiation treatment planning system using the remote desktop function of a computer operating system: a preliminary report

We developed a web-based, remote radiation treatment planning system which allowed staff at an affiliated hospital to obtain support from a fully staffed central institution. Network security was based on a firewall and a virtual private network (VPN). Client computers were installed at a cancer centre, at a university hospital and at a staff home. We remotely operated the treatment planning computer using the Remote Desktop function built in to the Windows operating system. Except for the initial setup of the VPN router, no special knowledge was needed to operate the remote radiation treatment planning system. There was a time lag that seemed to depend on the volume of data traffic on the Internet, but it did not affect smooth operation. The initial cost and running cost of the system were reasonable.

[A teleradiotherapeutic network for lymphoma patients within the competence network malignant lymphomas]

PURPOSE

The aim of the subproject "Radiotherapy" within the competence network malignant lymphoma, funded by the Federal German Ministry of Education and Research (BMBF), was to build-up an electronic imaging transfer between five University departments of Radiation Oncology to improve communication between study centers and reference centers.

MATERIALS AND METHODS

We describe our experiences with these modern teleradiotherapeutic possibilities, its feasibility within mutticentric clinical trials.

RESULTS

Telemedical functions could successfully be integrated into the existing quality asssurance programs of radiotherapy. Since January 2001 more than 700 patients (trials HD10-HD15 of the German Hodgkin Study Group, GHSG) could be assessed after digital transfer via internet, on mobile data carriers or an ISDN-connection in the radiotherapy reference center Cologne. Transfer of digital imaging between participating study centers and the radiotherapy reference center allows immediate or a short-term evaluation of adequacy of treatment fields by expert radiation oncologists before the start of radiotherapy. This improves dialogue and consensus between radiotherapy reference centers and study centers and thus contributes towards high radiotherapy quality for lymphoma patients.

CONCLUSION

The long-term aim is to network all those hospitals, institutions and private facilities taking part in the GHSG trials to achieve an integrated system of cooperation. This improves dialogue and consensus between the radiotherapy reference center and the study centers and thus contributes towards high radiotherapy quality for patients with Hodgkin's lymphoma.

Initiation of a teleradiotherapeutic network for patients in German lymphoma studies

PURPOSE

Deviations of radiation treatment portals and dose from prospective treatment plans are unfavorable prognostic factors for lymphoma patients. Therefore, an extensive radiotherapy quality assurance program is used in the ongoing German lymphoma studies. The introduction of teleradiotherapy offered the opportunity to optimize and simplify the workflow of these quality assurance programs. The purpose of this report was to evaluate the feasibility of teleradiotherapy and to describe our experiences with these innovative tools.

METHODS AND MATERIALS

During this pilot phase, five radiotherapy centers were equipped with the hardware and software that guarantees a rapid and high-quality transfer of imaging data, as well as real-time teleconferences. The workstation consists of standard PCs with Windows NT as the operating system and the commercial telemedicine software Hipax.

RESULTS

As a first step, imaging communication between the radiotherapy reference centers in Cologne and Homburg/Saar was established. Subsequently, three additional radiotherapy departments (Universities of Berlin, Münster, and Munich) with large numbers of lymphoma patients were connected. Other study centers delivered digital imaging on mobile data carriers or via an Integrated Services Digital Network point-to-point connection. Communication units were completed for interactive teleconferences. A facility for central online documentation was installed. Telemedical functions were integrated into the ongoing radiotherapy quality assurance program. Since the introduction of a teleradiotherapeutic workstation in the radiotherapy reference center in Cologne in January 2001, the images of 10% (n = 228 patients) of all reviewed cases of the ongoing Hodgkin's disease 10-12 trials were delivered digitally. The amount of digitally available imaging is continuously increasing.

CONCLUSION

The introduction of teleradiotherapy improved the dialog between the radiotherapy reference centers and study centers and thus contributed toward high radiotherapy quality for lymphoma patients in Germany.

An integrated service digital network (ISDN)-based international telecommunication between Samsung Medical Center and Hokkaido University using telecommunication helped radiotherapy planning and information system (THERAPIS)

This study introduces the integrated service digital network (ISDN)-based international teleradiotherapy system (THERAPIS) in radiation oncology between hospitals in Seoul, South Korea and in Sapporo, Japan. THERAPIS has the following functions: (1) exchange of patient's image data, (2) real-time teleconference, and (3) communication of the treatment planning, dose calculation and distribution, and of portal verification images between the remote hospitals. Our preliminary results of applications on eight patients demonstrated that the international telecommunication using THERAPIS was clinically useful and satisfactory with sufficient bandwidth for the transfer of patient data for clinical use in radiation oncology.