Informatics in radiology: DICOM-RT-based electronic patient record information system for radiation therapy

Comprehensive clinical imaging data and additional relevant information are crucial for the planning and delivery of radiation therapy in patients with cancer. Multiple stand-alone systems that make use of technologic advances in imaging, treatment planning, and treatment delivery acquire or generate key data during the course of radiation therapy. However, the data are scattered in various systems throughout the radiation therapy department, thereby compromising efficient clinical work flow. In 1997 and 1999, the Digital Imaging and Communications in Medicine (DICOM) standard was extended from radiology to radiation therapy with the ratification of seven DICOM-RT objects. These objects helped set the standard for (a) data integration and interoperability between radiation therapy equipment and information systems from different manufacturers, and (b) the use of DICOM diagnostic images in radiation therapy. More recently, key radiation therapy imaging and informatics data have been integrated to form an open-architecture comprehensive radiation therapy electronic patient record (ePR) system. The benefits of such a DICOM-RT-based ePR system are threefold: it can be used as a foundation for performing effective and efficient clinical services, as a common platform for radiation therapy data exchange and expert consultation, and for medical imaging informatics research in developing innovative decision support tools and a knowledge base for improved treatment with radiation therapy.