@misc{oai:repo.qst.go.jp:00062629,
 author = {Ando, Yutaka and Seki, Masayoshi and Mukai, Masami and Tanikawa, Takumi and Kobayashi, Akira and Tsujii, Hirohiko and Tsukamoto, Nobuhiro and Kawaguchi, Osamu and 安藤 裕 and 向井 まさみ and 谷川 琢海 and 小林 暁 and 辻井 博彦 and 塚本 信宏 and 川口 修},
 month = {Jun},
 note = {Purpose: To verify the dose distribution and treatment plan is very import and inevitable for a radiation oncologist. We developed the viewing software that can display the radiotherapy data (DICOM-RT Object) for a physician. The physician can issued the approval of the radiation plan by using this software. Methods: The software was written by the java and can be updated by the Java Web Start function in a hospital. We decide that this software is distributed under the open source criteria. Results: Physicians can easily display the DICOM-RT Object (RT image, RT plan and structure set) and also share the information. If he confirmed a treatment, he can change the approval status of the DICOM-RT Object. Discussion: Using this software, radiation oncologist can confirm the treatment plan and dose distribution quickly and issue the approval of the treatment with the DICOM approval module. This process conforms to the IHE-RO scheduled workflow that is investigated by the IHE-Japan RO group.
1. Introduction
The Integrating the Healthcare Enterprise (IHE)[1] is expanding into the radiation therapy domain in Japan. The IHE-J[2] Radiation Oncology Working Group (RO-WG) was organized in February 2006 and is in active. The Japanese workflow is discussed and the flow consists of the treatment planning, treatment scheduling, daily treatment, treatment summary and follow-up. In these workflow, to verify the dose distribution and treatment plan is very import and inevitable for radiation oncologists. We developed the tool for viewing DICOM-RT objects. The physician can observe the radiation plan/dose distribution and can issue the approval of the radiation plan by using this software.
2. Methods
The software was written by the java made by the java SDK (standard edition) 1.5 and java-3d [3]. The viewer software can be delivered by the network environment. This software can be updated by the Java Web Start. The Java Web Start is based on the Java Network Launching Protocol[4]. When the viewer starts up, the framework of the Java Web Start check the software. If the client software is older than one in the web server, the newer software will be downloaded automatically. We defined that the approve function can issued the three statuses of approval (unapproved, approved and rejected). The radiation oncologist can make the new DICOM-RT objects with the new approval status by our software. The objectives of the approval are (1) RT image, (2) RT Plan and (3) Structure set. But this software can issue only the approval to RT Plan and Structure set. 
In Japan, there are few DICOM-RT viewers. Many radiation oncologists want the viewer but the Japanese market hardly offers the software. We decide that this software is distributed under the open source software. We apply this software to the GNU GENERAL PUBLIC LICENSE Version 2 (Free Software Foundation, Inc.). We establish the web distribution and we want to bring up the DICOM-RT viewer community.
3. Result
Physicians could easily display the DICOM-RT Object (RT dose, RT plan and structure set) and also share the information about a patient. If he confirmed a treatment plan/structure set, he can change the approval status of the DICOM-RT Object. Fig. 1 shows the viewer image. In the left section there are thumbnail images and in the right section DICOM-RT objects are displayed. The viewer can show the dose
distribution, contours, beam positions and the images.
Fig. 1 Images and treatment plan/dose are displayed by the software.
The approval function is invoked by a press of a right-mouse-button. The approved object will be stored a new DICOM-RT object into a hard-disk with the DICOM approval module.
Fig. 2 Approval function. Physician can change the status to approval from unapproved.
4. Discussion
Using this software, radiation oncologist can confirm the treatment plan and dose distribution quickly and issue the approval of the treatment with the DICOM approval module. We think that this software is necessary in the Electronic Medical Record (EMR) environment. It is not necessary to install this software into desktop computers. The Java Web Start will decrease the labor of the software maintenance. We chose the Java Web Start mechanism for updating software. This method is very easy for
maintenance the software and a reliable method. We propose the workflow (display, confirmation and approval) for the treatment planning. This workflow of the radiation treatment process conforms to the IHE-RO scheduled workflow that is now investigated by the IHE-Japan RO-WG. In future, the workflow will be modified, and then we will be able to revise the software.
5. Conclusion
We developed the DICOM-RT viewer and distribute our application as open source software. We want to improve the application with an OSS community. The RT-Viewer can be downloaded from our web site. ( http://www.global-for.com/html/Product_E-004.html )
References
[1]IHE Integrating the Healthcare Enterprise: web site http://www.ihe.net/
[2]IHE-J: web site http://www.ihe-j.org/
[3] Java 3D: web site
http://java.sun.com/products/java-media/3D/forDevelopers/J3D_1_2_API/j3dguide/index.html
[4] Java Network Launching Protocol: web site
http://java.sun.com/products/javawebstart/download-spec.html, CARS2008 ( 22nd International Congress and Exhibition )},
 title = {Development of Open Source Radiation Oncology Viewer with Verification and Approval Function based on IHE-RO Workflow},
 year = {2008}
}