How people and technology work together to deliver high-quality radiation therapy

LCRP chief medical physicist explains three automated software programs that help improve the patient experience during radiation treatment

If your cancer diagnosis requires radiation therapy, there’s a team at the Nancy N. and J.C. Lewis Cancer & Research Pavilion that will have a plan in place before you even start your treatment. The team consists of medical physicists and dosimetrists, and most recently, automated software to ensure you get the highest quality of care safely.

At the beginning of 2022, the LCRP started using three new products for radiation treatment – ChartCheck, ClearCheck and EZFluence. These software programs were developed by a company called Radformation, led by a group of physicists and dosimetrists that have a goal very familiar to the LCRP – helping cancer patients receive treatment faster with safer, smarter radiation treatment plans.

Radiation treatment planning is the science of measuring or calculating radiation exposure. The plan will determine many things including the position the patient lays, the position of the equipment and where radiation will be delivered while minimizing exposure to healthy cells and tissue. The plan is approved by a medical physicist and radiation oncologist. It’s reviewed frequently throughout a patient’s treatment to ensure quality and safety.

Related Article: What is radiation treatment planning?

How automated software helps the process

Two of the products – ClearCheck and EZFluence – are used by the dosimetrists to develop the treatment plan, says Caleb Price, chief medical physicist at the LCRP. These programs automate a lot of the manual work and produce high quality plans in a third of the time. The team then reviews these plans, makes any adjustments they feel necessary and chooses the best one for each individual patient.

“These are high intensity plans,” Price says. “They require a more thorough calculation and more detail. Generating these plans faster gives us time to make adjustments so that the plan meets our standards. Nine times out of 10, we can accept the plan generated by Radformation as is because it’s so good.”

For the patient it may mean a quicker turnaround to begin treatment. But you can rest assured, the plan is thoroughly inspected by the medical physicist and radiation oncologist to ensure the highest quality of care and safety.

The third product, ChartCheck, is used by the medical physicist throughout your radiation therapy treatment. The medical physicist is responsible for the safe and accurate delivery of radiation. So from the time your radiation oncologist writes the prescription and provides any additional details, the medical physicist is responsible for the plan put in place and the delivery of that plan throughout your treatment.

One way they do that is with treatment inspections. Every five sessions, a medical physicist will do an audit of your treatment plan to ensure the plan is being delivered as intended. This is done for each and every radiation therapy patient whether they are getting external beam treatment on TrueBeam or CyberKnife® or brachytherapy.

“We manually go line-by-line checking logs versus what we planned. We make sure the equipment was in the right position; the patient was in the right position – up, down, left, right,” Price explains. “It takes a lot of time and focus.”

Now with ChartCheck, they have some additional help. This software automates the process, and instead of every five days, produces a report on each individual patient every session. The physicists can review the report and compare it to the intended plan to make sure everything is going as planned.

Additionally, there are alert thresholds in place so if for any reason something is not going according to plan, the medical physicists will get an email to check on that patient.

“Checking every five fractions is frequent enough that we can make adjustments throughout a patient’s course of treatment to deliver high-quality care,” Price says. “ChartCheck takes that a step further and will alert us on a daily basis to opportunities to improve a patient’s treatment.”

So as a patient, you may never hear about any of these three products. You may never even see a medical physicist or dosimetrist during your visits, but the LCRP is committed to the people and technology to help you get better quicker and safer.

“All of these things are happening behind the scene, and you may have no idea, but they all impact the quality of care that you get,” Price says.

“I think what makes this facility so great is they continue to invest in things that really do contribute to the overall quality of patient care. That does make this a special place to work because they are interested and invested in not just the things you can put on a TV or a billboard, but the behind-the-scenes things that we do.”