Background

Radiation oncology is undergoing a rapid and radical transformation driving an exponential growth in the size, complexity, and quantity of data generated during the treatment process. This is partly due to the large number of images that are generated at each step of the treatment process - from diagnosis, treatment verification to follow-up

As a result, RT digital data storage and access demands on radiation oncology departments need to be reconsidered and improved.

Enterprise PACS Solutions

Many hospitals have invested huge funding into personnel and software to provide Hospital Information System (HIS) implementation and integration with sub-systems, as e.g. LIS (Laboratory Information System), RIS (Radiology Information System), or PACS (Picture Archiving and Communication System). PACS, which was originally designed as a tool for facilitating radiologists in interpreting images more efficiently, is evolving into a hospital-integrated system storing DICOM data that frequently reaches far beyond radiology.

However, the proprietary nature of these systems limits their usefulness in radiation oncology because often they are incapable of viewing and analysing DICOM RT objects.

Radiotherapy Systems

In a RT department, patient management and workflow is handled by the Oncology Information System (OIS). At the present time the oncology management system is usually connected to linear accelerators on which the majority of patients are treated using a proprietary interface. In addition to the treatment machines and the OIS, much of the work in the RT department is performed on specialist post-processing workstations, such as treatment planning systems.

Although information generated during the RT planning process are standard DICOM objects, most vendors store the information either in proprietary format or in DICOM format in a proprietary database.

Oncology-Specific PACS Solutions

Recently some PACS and RT equipment vendors brought to the market oncology-specific PACS solutions which combine the storage capability of enterprise PACS with features designed specifically to

support today’s image-based oncology programs,
view the DICOM-RT image file layers crucial to oncology diagnosis and treatment planning, and
consolidate the often fragmented patient data information providing integration with EMR (Electronic Medical Record) and OIS.

The risks and benefits of storing patient data in a local, and probably temporary, department-specific PACS solution should be well considered.