Related Experiment Video
Updated: Oct 25, 2026
Radiation Planning Assistant - A Web-based Tool to Support High-quality Radiotherapy in Clinics with Limited Resources
Published on: October 6, 2023
Harmonizing Radiotherapy Data Standards: A Comparative Analysis of OMOP, CDISC, FHIR, NAACCR, and OBO Foundry with an
Ying Xiao1, Georgina Kennedy2, Rebecca L Baker3
1University of Pennsylvania, Philadelphia, PA.
Purpose:
This Special Report analyzes current radiotherapy data standards, determines which radiotherapy data elements should propagate between them, and identifies the barriers to that propagation to improve interoperability and data utilization in clinical care and research.
Methods:
We compared five data standards-OMOP, CDISC SDTM, FHIR, NAACCR, and the Operational Ontology for Oncology (O3)-and one ontology framework, the OBO Foundry, for radiotherapy data representation, strengths, limitations, and implementation maturity, and examined harmonization initiatives including NRG's O3-based conversion frameworks, CodeX mCODE, and ESTRO and IAEA efforts. We then scored a 90-item benchmark drawn from radiotherapy operational and trial-reporting requirements, partitioned the radiotherapy items by whether and where they should propagate, and matched each barrier to a remediation route and owning body.
Results:
Counting only unqualified matches, O3 covered 46 of 62 radiotherapy-specific items (74%) versus 15 (24%) for OMOP, 12 (19%) for NAACCR, 11 (18%) for FHIR, and none for OBO Foundry; on the 28 general clinical items the ordering reversed (OMOP 79%, FHIR 71%, NAACCR 46%, O3 25%, OBO Foundry 4%). Each standard is strongest on the items its target function was built to serve. Wholesale propagation is therefore unwarranted: 20 course-summary elements should converge across standards, 26 planning and adaptive elements warrant selective adoption, and 16 voxel- and machine-level artifacts should be referenced by DICOM unique identifier rather than replicated.
Conclusions:
Harmonization requires ontology-driven approaches using O3 as the semantic backbone with mappings to FHIR, OMOP and CDISC, applied to a defined tier of elements rather than the full element set. The principal barriers are process barriers-structural, terminological, burden-related and tooling-related-each with a named owner and an existing route. Standardized formats alone are insufficient; they require robust information systems, validation, and governance. Harmonization improves real-world data utility but cannot resolve biases inherent to nonrandomized data. Coordinated international collaboration remains critical for advancing precision radiation oncology.
More Related Videos
08:13Evaluations of Oxygenation and Vascular Perfusion in Pre-Clinical Models of Cancer and Wound Healing Using OS-DCE OAI
Published on: April 7, 2026
06:20Irradiator Commissioning and Dosimetry for Assessment of LQ α and β Parameters, Radiation Dosing Schema, and in vivo Dose Deposition
Published on: March 11, 2021
Related Concept Videos
01:13Radiological Investigation III: Pulmonary Angiogram and PET Scan
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
01:30Radiological Investigation II: MRI and Ventilation Perfusion Scan
Magnetic Resonance Imaging (MRI) and Ventilation Perfusion Scans are two radiological investigations that offer detailed diagnostic images of the body, particularly lung structures.
MRI
MRI uses magnetic fields and radiofrequency signals to distinguish between normal and abnormal tissues. This technology provides a more detailed diagnostic image than CT scans, enabling it to characterize pulmonary nodules, stage bronchogenic carcinoma, and evaluate inflammatory activity in...