An All-In-One Visualization Tool for Offline Adaptive Radiotherapy
Abstract
Purpose
To develop and evaluate an intuitive all-in-one visualization tool for assessing delivered dose on daily CBCT. Daily dose calculations introduce a longitudinal perspective to classic plan metrics such as DVHs, objectives, and clinical goals, requiring clear visualization of time-points and deviations. The proposed tool presents this information in a single overview. To support efficient multidisciplinary decision making, the tool was evaluated by radiation oncologists (RO), medical physicists (MPE), dosimetrists (MPA), and radiation technologists (RTT) utilizing the System Usability Scale (SUS).
Methods
The script was created using the Eclipse Scripting API (v18.1, Varian). A heatmap summarizes clinical goals and time-points with color-coding based on the ‘Passed’, ‘Failed’ or ‘Variation Acceptable’ statuses embedded in clinical goals. Details can be accessed by hovering over a clinical goal/time-point cell, revealing the numerical value and deviation from the original plan, or by selecting a cell to display a DVH-comparison with the initial plan, and a longitudinal trend for the selected goal. For validation, a breast cancer treatment plan was recalculated on five CBCTs (HyperSight) using the full fractionation dose. CTV and OAR contours from the planning CT were propagated using deformable image registration. Usability was assessed with the ten SUS questions, completed by 4 ROs, 2 MPEs, 2 MPAs, and 2 RTTs after a short demo of the tool.
Results
The mean SUS score was 85.0±10.1, indicating excellent usability. Users found the tool intuitive and informative for evaluating CBCT-based doses. Visualization of accumulated dose was requested as a possible enhancement. Highest scores were associated with system consistency and low complexity, indicating a robust and well-integrated design. Lowest scores related to learnability and user confidence, suggesting that onboarding could further improve usability.
Conclusion
The visualization tool enables intuitive longitudinal assessment of delivered dose on daily CBCT and was positively evaluated across all involved disciplines.