god morgen

This talk is about OpenREM - software to help us physicists do a better job

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OpenREM: Radiation Exposure Monitoring for physicists

Ed McDonagh, The Royal Marsden

MedFys 2015 conference, Kvitfjell, Norway. 2nd-4th February

Why automated dose monitoring?

Sample sizes

Level of detail

Accuracy

Because we can!

Why create my own software?

Data were available

Tools were available

• David Clunie's DoseUtility
• Python's pydicom
• Bash scripting, XlsxWriter...

Nothing on the market did what I needed

Freedom!

Design criteria

Harvest the dose related data that I want

i.e. everything I can get my hands on...

Customisable

Low cost

Free

Documented

Compliant with data protection law

Data protection requirements

No patient identifiable data is retained

Not required for

• population dose monitoring
• optimisation

Accession number is used for

• individual patient dose investigations

Patient tracking is of interest for interventional imaging - use accession numbers on a case-by-case basis?

What I didn't want to see...

(meaningless) Effective dose calculations

Cumulative dose tracking

Dashboards for referring physicians and justifying radiologists

Solution:

Open source - GPLv3 licence

Hosted at Bitbucket.org in a git repository

Python, Django, pydicom, XlsxWriter, Celery and RabbitMQ

Sources of dose information:

Radiation dose structured reports

• CT
• Fluoroscopy
• Others...

Mammography images

Radiography images

Philips CT dose summary images

CSV files containing height and weight

Planned sources of dose information

Toshiba CT dose summary images

Siemens Arcadis Varic fluoroscopy structured report

Importing data

No DICOM C-Store (yet)

• Use another DICOM listener, eg Conquest
• Or copy as files

Import on the command line:

                
openrem_rdsr.py structuredreport.dcm
openrem_mg.py mammographyimage.dcm
openrem_dx.py radiographyimage.dcm
openrem_ctphilips.py ctimage.dcm
            
            

Automate with a shell script/Conquest

Enough words!

Authorisation

View group: Can only browse data

Export group: Can also export data to spreadsheets

Admin group: Can also import height and weight data and delete studies

Filtering study list

Viewing study details

Uploading csv file with patient size information

Choosing column headings for import

Exporting data to spreadsheets

Data exports

Images of excel spreadsheets and charts removed from this version

Has OpenREM enabled me to do a better job?

Yes!

But it does create even more work...

Outlier doses

Previously discounted as

• Transcription errors
• Unusual cases

Now we know they are real patient doses, and can investigate

• Initially from the comfort of a desk with the data (and images)
• Then in conjunction with the radiographer with data, images and experience

Together we can improve practice

• We understand better the decisions they need to make
• They learn from us how to make better decisions with practical examples

By-products of regulatory dose surveys

Now find out all sorts of things...

...which spawns new projects!

Comparisons of nominally dosimetricly equal protocols

Comparisons of protocols across scanners/sites

Accidental protocol mistakes

Change in speed

Comparing new scanners against old

Monitoring effect of change

Comprehensive data for individual patient dose calculations

Current developments

The live demo site has charting feature that is not yet released

demo.openrem.org/openrem

Future developments

• Fluoroscopy skin dose mapping
• Initial code and ideas


• DICOM Store and Query-retrieve
• Manual and scheduled via the OpenREM web interface


• Visualisation of mA modulation
• Storage of per-slice CT mA/CTDIvol data
• Storage of scan projection radiographs


• Contributing to regional and national databases
• Creation of RDSRs for all modalities from the database data

How to get started

The website

openrem.org

Have a play with the demo site

demo.openrem.org/openrem

Or follow the link from the website...

The documentation

docs.openrem.org

Or follow the link from the website...

What do I need?

A computer - Linux or Windows,
(or a Mac probably)

Time

Source data - preferably via the network

Follow the instructions...

How to get involved

Play around with it - see what it does and doesn't do, then...

Coding and documentation

Get/fork the code - git repository on Butbucket (docs included) at bitbucket.org/openrem/openrem

Follow the link from the website...

Make your changes, send in a pull request

Ideas and questions

Email the user group at groups.google.com/d/forum/openrem

Follow the link from the website...

Advocacy

Tell your colleagues

Mention it in papers and talks that make use of it

Who are the authors of OpenREM?

Me

An hours commute each way to work can be useful!

David Platten, Northampton General Hospital, UK

Added radiography, adding charting, docs, general fixes

Jonathan Cole, The Royal Free, UK

Customised mammography export, docs, general fixes, currently looking at skin dose mapping

You?