Development of an Automated TG-275 Treatment Plan Verification Tool Integrating Monaco TPS and Mosaiq OIS Data Comparison
Abstract
Purpose
To develop and implement an automated quality assurance application for radiation therapy treatment plan verification following AAPM TG-275 guidelines, enabling comprehensive comparison between Elekta Monaco treatment planning system (TPS) and MOSAIQ oncology information system (OIS) data.
Methods
A Python-based application with graphical user interface was developed to extract treatment parameters directly from Monaco plan files and compare them against corresponding MOSAIQ database entries. The tool parses Monaco prescription files, beam parameters (tel.* files), and DVH statistics, then queries the MOSAIQ SQL database to retrieve matched field data. Parameters compared include: patient identity verification, prescription dose and fractionation, beam name, monitor units, beam type, isocenter coordinates (with unit conversion from mm to cm), gantry and collimator angles, VMAT start/stop angles, field dimensions, beam energy, and SSD. The application implements tolerance-based mismatch detection with severity categorization (Critical, Major, Info) and verifies MOSAIQ workflow completion including prescription approval, plan document approval, and treatment calendar population.
Results
The application successfully automates the manual chart check process required by TG-275. Initial testing demonstrated accurate extraction of beam parameters from Monaco plan structures and correct matching with MOSAIQ TxField and TxFieldPoint database tables. The GUI provides clear visualization of discrepancies through color-coded severity indicators. Isocenter coordinate comparison required implementing proper unit conversion (Monaco mm vs MOSAIQ cm) and 3D distance calculations for tolerance verification.
Conclusion
An automated TG-275 verification tool was successfully developed that significantly reduces manual chart check time while improving consistency and reducing the potential for human error in treatment plan verification. The modular design allows adaptation to other TPS/OIS combinations.