DOS 515 - Week 2 Discussion
Initial Post: There's an App for That
In my daily practice, I make use of several pieces of computing hardware, a raft of software packages, several servers, and a wide variety of network components to let everything operate together.
My desk computer is a somewhat older model with a CPU dating from 2009, even though it was built and purchased in 2012. The reason the hardware is old is that this is a "certified" configuration that has been thoroughly tested by the makers of our main treatment planning software, XiO. Unfortunately this means that all of the rest of our software that doesn't require a certified configuration is held back by the slower performance. We have upgraded the memory on our computers to 20GB to give ourselves a bit of a performance boost, but that only helps us by letting us have many applications open simultaneously; it doesn't actually speed anything up other than not having to spend time closing and reopening apps and not having to write temporary files to the hard disk as often. These are modest speed bumps, but nothing like what a better CPU would give us.
All of our computers are equipped with two 24" monitors. This is a luxury that most people don't realize they are missing until they've been able to work with more than one screen. We can run several apps simultaneously and have them up side by side instead of having to shuffle windows around, wasting time with hiding and showing various documents and windows.
Here are some of the applications I use in any given week:
- MIM - This is where I spend about three quarters of my day. I use it for multimodality fusion, deformable registration, contouring, dose compositing, plan evaluation, and report generation.
- MOSAIQ - This is out Oncology Information System (OIS) which tracks all of the treatment details for each patient such as scheduling, plan documentation, treatment parameters, daily setup, and more.
- IMS - This is a web application that we have had customized for our department's needs. MOSAIQ is not very good for tracking the planning process, so we use IMS to track which dosimetrists, physicists, and physicians are assigned to each patient, and we track the current status of each of the many planning steps, including replans, QA plans, comparison plans, education plans, and so on. IMS is able to pull data from MOSAIQ, but I believe the data transfer is only in one direction, so we still need to update MOSAIQ ourselves when a plan is complete and ready to be officially documented and approved.
- Outlook - This is an email and calendar application.
- Chrome - This is quite a nice web browser. I use it for research and to access the IMS web application.
- WebEx Connect - This an instant messaging application that lets people send quick messages to each other. We can also easily share our screens with each other through the same app.
- iTunes - This is not job-related, but I listen to music during the day while I'm contouring to help keep my mind from wandering.
- XiO - This is our workhorse planning system. I have not yet learned to create radiation plans from scratch, but I use it to run QA plans on mid-treatment followup CTs. This process involves aligning the new CT with the plan CT in MIM, recontouring anything that has changed, and then using XiO to drop the current beam plan onto the new CT to see what happens. Proton beams are very sensitive to changes in anatomy since they are tuned to travel to a specific depth and stop. This QA process lets us get an idea of whether a replan might be needed at some point in the treatment process.
- RayStation - We are slowly phasing in RayStation as a replacement for XiO. It has a much faster calculation algorithm for pencil beam scanning than XiO, but we are currently being held back by some changes and improvements that won't come along until version 4.5 is FDA-cleared.1 For now, we mostly just tinker with it to get some experience with it.
- GE AW (Advanced Workstation) - We use this to pull CT images from our GE CT scanner and send them to MIM. This software is capable of doing more than that, but that is the only thing we use it for.
On a daily basis, I will access resources stored on several servers, including:
- The MIM server - This acts as a PACS for our department. It stores all of our diagnostic imaging data, our treatment planning CTs, planning data sent from other institutions, and in most cases it will also end up storing copies of our treatment plans too.
- The XiO servers - XiO uses a client/server model in which all treatment data is housed in a central database. When we log in to XiO on our local machines, we are actually connecting to one of a pool of XiO servers that all share the common database.
- Our file server - Our personal workstations are not backed up, so anything that we want to be sure that we won't lose must be kept in our home folders on the file server, which IS backed up.
- The RayStation servers - We use Citrix to remotely connect to a pool of RayStation machines that are physically located in our datacenter. When we use RayStation, it feels like we are using it locally, but the app is running on the server.
We have both wired and wireless networks to connect everything together. Our wired network provided high speed access to everything, but of course you have to be plugged in to use it. Our wireless network allows us to access the same resources on a roaming laptop, which is very useful for meeting in the conference room.
My iPhone is another big part of my working life. Besides all of its functions in my personal life, I use it to check work email and get reminders of meetings and appointments. I don't have any work-specific apps installed on it.
The system that is newest to me is RayStation. As I mentioned, it is a treatment planning system that has several advanced functions relating to pencil beam scanning, which is the latest and greatest proton therapy technology. In the photon world, it has many advanced plan optimization tools such as multicriteria optimization (MCO) that lets you manually nudge plan parameters one at a time or in groups to achieve more favorable dose distributions. This technology hasn't made it to the American proton market, but it is supposed to be coming in version 4.5, which is already in use in Europe, but hasn't been cleared by the FDA yet. RayStation has a lot of potential, because it has the same calculation algorithms as every other planning system (the makers of RayStation own the technology and license it to everyone else2) but it is not weighed down by decades of legacy code. It is a fresh-looking, well thought out package that is fast and fully buzzword compliant. It even does things like take advantage of the specialized processing capabilities of modern graphics cards to run calculations that are well-suited for that architecture. I have had some introductory training on the system, but since it is not part of my job duties, I haven't been able to play with it as much as I'd like to.
- RayStation 4.5 news. RaySearch Laboratories Website. http://www.raysearchlabs.com/en/RayStation/RayStation-45-News/. Accessed October 22, 2014.
- Commercial partners. RaySearch Laboratories Website. http://www.raysearchlabs.com/en/About-RaySearch/Business-model/Commercial-Partners-NEW/ Accessed October 22, 2014.