Prototype of the Radiation Oncology Teaching Files System for Charged Particle Radiotherapy

[Purpose] Our hospital started the charged particle therapy since 1996, after the world\u27s first development of Heavy Ion Medical Accelerator in Chiba (HIMAC). We have been obtaining the many clinical results, and the number of patients has exceeded 6,100 cases by December 2011. At the same time, we recognize another mission of us. We should promote the spread of medical knowledge, increasing standardization of radiation treatments and education of the professionals in conjunction with the charged particle therapy, which we have been experiencing. Recently the constructions of new institutions for charged particle therapy are in their courses, not only in Japan, as well as all over the world. Our hospital are accepting many visitors as medical doctors, radiologists, and physicists from those newly planned medical institutions worldwide and having many opportunities to provide with the training to them, for instance, regarding radiation therapy planning. Based upon our experiences, we have developed the prototype of the radiation oncology teaching files system for charged particle therapy.\n[Methods] We adopted the PowerPoint of Microsoft as a basic framework of our teaching files system. The teaching physicians who are in charge of the selection and produce of the contents of the teaching files are familiar with the PowerPoint through daily usages for the conference and/or the clinical report. These physicians are able to edit and prepare the following information in PowerPoint by themselves. Clinical history, stage and condition of the disease, treatment plan, dose distribution, follow-up information, effect/side-effect of the radiation therapy, the assessment of the treatment and key images are prepared. The method of image viewing is as follows. When users clicks the key images on PowerPoint, a "control file\u27\u27, containing index information linked to the DICOM images is called internally. The DICOM image viewer (produced by TechMatrix Corporation), which is related to the "control file\u27\u27, starts up and automatically load and show the images based upon index information described in the "control file\u27\u27. At the same time, the image layout, annotation and presentation state are recorded into the "control file\u27\u27 as well, which creators originally intended to show. Being the initial view evoked as a starting point, users can access to the all DICOM images of studies by normal operation like paging and window level manipulation. It was used to be needed for experts to insert the execution command of viewer and file path information to the related DICOM files into each PowerPoint page. After the version-up of the viewer system, the process to define the relationship between PowerPoint and contents DICOM files has become much easier as follows; Step1) Contents creators just layout images in the viewer, Step2) Just click the contents export icon.Only those operations in the viewer can export "control file\u27\u27 which contains information about image files and layout. At the same time, the viewer creates new PowerPoint file, in which key image is attached automatically, keeping the link with the image files exported above. [Results] We have made 11 cases for teaching files contents along with the following organs group, (1) head and neck, (2) skull base, (3) lung (2 cases), (4) liver, (5) musculoskeletal (sarcoma and sacral chordoma), (6) prostate, (7) kidney and (8) rectum (2 cases). All patients\u27 privacy information is eliminated in the process of production of teaching files. Even DICOM tags containing privacy information (patient name, disease entity and institution name etc.) are automatically replaced with unique code in this system. Users can select their interest disease from the menu, and easily review the images and explanation of each case. We have succeeded to decrease the contents production time and effort since teaching staff can select case images and attach them into a PowerPoint file by themselves. Before the system installation, each content production time ranged from 3 to 6 hours. After the introduction of this mechanism, we can finish creating control file in 15 to 30 minutes.\n[Conclusion] We have developed the teaching files system that enablers easy editing and anonymization. By using our export function of the viewer any physician can create teaching files easily and effectively. We are now adding new cases into our teaching files which we have applied charged particle therapy and showing the points to notice through the process of radiation therapies. We expect that we can improve the safety and accuracy of charged particle therapy by using our teaching files system substantially.CARS201