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. 2014 Jun 23;9:145. doi: 10.1186/1748-717X-9-145

Table 1.

Requirements for safety

Data import, data registration and structure contouring
Minimal Enhanced Optimal
Import of all CT data with dicom coordinates
Import of all CT data with transposition of the dicom coordinates (lower error source)
Structures can be digitally locked by selected users
Import and export of treatment plans in dicom format
Registration based on dicom coordinates
 
 
Registration is digital lockable
 
 
Structures, which are connected to a treatment plan, can’t be changed (only copies or new structures can be created)
 
Requirements for treatment planning
Minimal
Enhanced
Optimal
Collapse cone or equivalent algorithm for the dose calculation of photons
Monte Carlo or equivalent algorithm for the dose calculation of photons
IMRT optimization with Monte Carlo or equivalent algorithm
Monte Carlo based radiation head model
IMRT optimization with a Collapse cone or equivalent algorithm
Conventional IMRT optimization comprises collimator and gantry rotation
Create sum plans of treatment plans calculated on rigid registered data sets
IMRT optimization with a direct aperture calculation
Volumetric IMRT optimization comprises collimator rotation and segment selection
Comparison of different treatment plans (calculated on any data sets) with simultaneous display of the isodose distributions, DVH and BEV
Monte Carlo or equivalent algorithm for the dose calculation of electrons
Creating of optimal DRR (DRR templates producible and manual adjustable)
Creation of check sum every working day (control of beam data)
More than one reference dose and point can be applied to a treatment plan (e.g. integrated boost)
 
Requirements for ROKIS
Minimal
Enhanced
Optimal
Import and export of all data in general readable dicom format (structures, treatment plans, CT/MRI/PET/… data sets, isodoses, verification images such as planar view images or CBCT data)
Treatment plans can be digitally locked by selected users
Automatic connection between patient, prescription treatment plan and verification images
Automatic link of the treatment plan to the corresponding patient
Unlocked treatment plans can’t be applied to a patient
 
Automatic link of the treatment plan to the corresponding target volume or clinical protocol respectively
 
 
After radiation the treatment plan can’t be changed or deleted (only copies can be made)
 
 
Positioning information is linked to the treatment plan
 
 
Positioning information and patient photo can be displayed in the treatment room
 
 
Remote control
 
 
Periodical upgrades available, (with no data loss, for example user defined templates)
 
 
High data integrity
 
 
Requirements for patient verification
Minimal
Enhanced
Optimal
Automatic calculation of the 3D correction vector of the treatment table (2D planar images and CBCT)
Automatic link of the verification images to the corresponding field of the treatment plan
Manual adjustment of the field edges of the verification field always possible
Automatic correction of the table by the system
 
 
Automatic link of the verification images to the corresponding treatment plan and patient
 
 
Correction data from offline analysis is automatically sent to the treatment system