August 18, 2020
Clinical Showcase: AAPM Abstracts Featuring Radformation Software
Attending the AAPM/COMP virtual annual meeting was a positive experience, and was a well-planned conference experience for clinicians and commercial partners alike. Radformation was pleased to have participated as an exhibitor in the vendor hall as well as the Vendor Showcase parallel track.

Several institutions submitted abstracts for clinical research involving Radformation’s software solutions. It’s always a pleasure to see how departments have incorporated these tools to improve their workflows and impact patient care. We’re happy to share some select abstracts here, which involves ChartCheck and EZFluence and covers topics from data extraction to time savings with 3D planning.

ClearCheck
M Moazzezi, K Moore, K Sysock, X Ray, K Kisling
(1) University of California San Diego, San Diego, CA, (2) Radformation, New York, NY
Using the ClearCheck API, UCSD extracted data for thousands of patients to train a knowledge-based dose prediction model. In addition, they were able to analyze hundreds of treatment plans and DVH data. The ClearCheck API functionality was released in v1.6 and is now available for clinics to leverage the power of scripting to gain access to large amounts of patient data for analysis.
J Hoisak, R Manger, G Kim, I Dragojevic
University of California, San Diego, La Jolla, CA
ClearCheck aided the UCSD team in automating plan checks with high-risk failure modes. Coupled with the department’s intelligent dynamic checklists (IDCs), the addition of ClearCheck for automated plan checking increased failure mode coverage for physician peer review to 97.8%. The use of automation in plan evaluation decreases clinical workload and allows for more concentrated focus on more complicated tasks.
EZFluence
D Wang, M Weiss, H Perlingiero, M Kalman, Y Hu, A Denittis
(1) Lankenau Hospital, Wynnewood, PA, (2) Bryn Mawr Health Center, Wynnewood, PA, (3) Lankenau Institute For Medical Research
Lankenau Hospital found that Forwarding-Optimizing-Fluence-Script (FOFS) or electronic compensator (e-comp) planning was superior to hybrid IMRT (H-IMRT) for whole left breast treatment planning. Analyzing 29 plans, the e-comp plans delivered more uniform prescription dose with less dose to heart and lung OARs, while simultaneously reducing hot spots and treatment time. As a result, Lankenau Hospital concluded that e-comp planning is a better alternative for their DIBH patients.
C K Matrosic, K C Paradis, M M Matuszak, University of Michigan, Ann Arbor, MI
The University of Michigan utilized EZFluence to test the feasibility of a field-in-field adaptive planning workflow. Replanning three previously treated clinical cases (3DCRT bladder, VMAT lung, and thoracic multi-metastatic treatment) yielded improvements in PTV D95% coverage, lung doses within clinical limits, and treatment plan quality similar to VMAT. The University of Michigan concluded that EZFluence could be used in an adaptive planning workflow for cases that exhibit large interfraction changes with minimum alterations to the current clinical workflow.
C Esquivel, A Tipton, L Patton, D Baldassari, B Lin
Texas Oncology San Antonio, San Antonio, TX
Texas Oncology compared traditional whole brain Field-in-Field plans with EZFluence generated plans. When assessing the total treatment planning times for each method, traditional planning time was found to take 7-20 minutes. Using EZFluence, the time required for the same plans was reduced to 4-8 minutes. Texas Oncology concluded that EZFluence generates whole brain FIF plans comparable to traditionally created plans (within 1%) with comparable physician review and a significant reduction in planning time.
C Esquivel, L Patton, B Doozan, K Nelson, D Boga, T Navarro
(1) Texas Oncology San Antonio, San Antonio, TX, (2) Texas Oncology, McAllen, TX, (3) Texas Oncology Brownsville,TX
Texas Oncology compared the use of EZFluence treatment planning software to traditionally planned field-in-field cases, including breast, whole brain, and rectum plans. The average traditional planning time was 10-20 minutes, with the use of EZFluence the average was found to be 4-9 minutes. Texas Oncology concluded that EZFluence is able to create comparable plans (within 1%) with a significant reduction in planning time. Additionally, using MapCheck and RadCalc, Texas Oncology was able to validate EZFluence for clinical use.
ClearCheck helps clinics save time with in-depth plan checks, quick plan comparison, and instant documentation.
EZFluence generates optimal fluence files and field-in-field plans that import directly into Varian Eclipse TPS.

written by Tyler Blackwell

Tyler Blackwell is a board-certified medical physicist with extensive clinical experience in radiation therapy. He is active in several AAPM committees, has served as secretary-treasurer for the Northwest Chapter of AAPM, and is an ABR orals examiner. Tyler dabbles in real estate investing and loves preparing breakfast for his two kiddos.

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