Witztum Alon, Jourani Younes, Hirata Emily Y, McNutt Todd, Tadic Tony, Brock Kristy K, Hong David S, Howard Michelle E, Krauze Andra V, Balter Peter A, Stockham Abigail L, Covington Elizabeth L, Xiao Ying, Popple Richard, Mayo Charles S
Department of Radiation Oncology, University of California, San Francisco, California.
Department of Medical Physics, Université Libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (H.U.B), Institut Jules Bordet, Brussels, Belgium.
Pract Radiat Oncol. 2025 May-Jun;15(3):290-299. doi: 10.1016/j.prro.2024.09.016. Epub 2024 Nov 13.
Tracking patient doses in radiation oncology is challenging because of disparate electronic systems from various vendors. Treatment planning systems (TPS), radiation oncology information systems (ROIS), and electronic health records (EHR) lack uniformity, complicating dose tracking and reporting. To address this, we examined practices in multiple radiation oncology settings and proposed guidelines for current systems.
A survey was conducted among members of various professional groups to understand dose reporting practices in TPS, ROIS, and EHR systems. The aim was to identify consistent components and develop guidelines.
We identified 6 treatment scenarios where current ROIS defaults fail to accurately represent dose totals. A standardized approach involving 3 reference point types - primary treatment plan reference, dose check, and prescription tracking - was proposed to address these scenarios. Standardizing naming conventions for reference points was also recommended for easier integration with EHRs. The approach requires minimal modifications to existing systems and facilitates easier data transfer and display in EHRs.
Standardizing reference points in commercial TPS and ROIS can bridge infrastructure gaps and improve dose tracking in complex clinical scenarios. This standardization, aligned with the American Association of Physicists in Medicine's Task Group (TG) 263, paves the way for continual development of automated, standardized, interoperable tools, enhancing the ease of sharing reference point information.
由于来自不同供应商的电子系统各不相同，在放射肿瘤学中追踪患者剂量具有挑战性。治疗计划系统（TPS）、放射肿瘤学信息系统（ROIS）和电子健康记录（EHR）缺乏一致性，使得剂量追踪和报告变得复杂。为了解决这个问题，我们研究了多个放射肿瘤学环境中的实践情况，并为当前系统提出了指导方针。
对各专业团体的成员进行了一项调查，以了解TPS、ROIS和EHR系统中的剂量报告实践情况。目的是确定一致的组成部分并制定指导方针。
我们确定了6种治疗场景，在这些场景中，当前ROIS的默认设置无法准确表示总剂量。提出了一种标准化方法，涉及3种参考点类型——主要治疗计划参考、剂量检查和处方追踪——以应对这些场景。还建议对参考点的命名惯例进行标准化，以便更轻松地与EHR集成。该方法对现有系统的修改要求最小，并便于在EHR中更轻松地进行数据传输和显示。
在商业TPS和ROIS中对参考点进行标准化可以弥合基础设施差距，并改善复杂临床场景中的剂量追踪。这种标准化与美国医学物理学家协会任务组（TG）263一致，为持续开发自动化、标准化、可互操作的工具铺平了道路，提高了共享参考点信息的便利性。
