Seeing the Whole Plan - a Comprehensive, Open-Source Dashboard for External Beam Treatment Plan Review and Quality Assessment
Abstract
Purpose
To develop and clinically deploy an open-source treatment plan review tool, PANORAMA, integrated with the treatment planning system (TPS) and oncology electronic medical record (EMR) to improve efficiency and standardization of external beam plan review in a community setting.
Methods
A standalone C# application was implemented using a vendor scripting API for TPS data access and an EMR data access API and is launched from within the TPS. The tool is routinely used by dosimetrists after plan completion and prior to physics submission, and by physicists during technical review before plan release for physician review, patient-specific QA, and treatment approval. The tool presents a dashboard of automated check results, including EMR-TPS prescription consistency, image acquisition parameters, structure naming and laterality, beam geometries, plan complexity, collision clearance, dose calculation settings, and extended dose constraint evaluations. Rulesets and protocol values are centrally administered and can be selectively displayed by user role; external corrective scripts may be launched from the application. The application runs locally, is audit-logged, and does not store PHI.
Results
From August 2022 to January 2026, over 11,000 plan instances representing more than 3,500 unique treatments were reviewed across all external beam techniques. Typical runtime was 20-30 seconds per plan. Surveyed users (n=11; 5 physicists, 6 dosimetrists) estimated a median time savings of 27 minutes per plan review (range 15 to 75 minutes; greatest for complex stereotactic plans) compared with performing a similar-depth manual review; re-review was shortened by referencing prior check results. Following implementation, institutional convention compliance became mandatory for plan approval and TG-263 adoption accelerated by flagging noncompliance in existing TPS templates.
Conclusion
A fast, transparent, open-source plan review application integrated into the TPS supported the prospective review of thousands of plans with substantial user-reported time savings and improved standards compliance, while remaining configurable and extensible.