Overview

Varian is sponsoring a next-generation planning competition, the first of its kind and one that will accomplish all of the following: (1) engage some of the best treatment planners in the world, (2) pit “human vs. machine” to gauge the current capabilities of knowledge-based auto-planning, (3) result in a “tips and techniques” presentation by the ultimate winner at ASTRO 2019, and (4) result in a RapidPlan model that will be distributed to all Eclipse customers, giving them a potentially useful new tool in their treatment planning toolbox.

To understand the aims, methods, and instructions on how to participate, please see the following instructions, which we have broken into three parts.

Part 1: Overview of Aims and Methods

For an overview of the goals and format of this planning event, please watch the video where we interview Anthony Magliari, Senior Research Scientist in Varian’s Office of Medical Affairs.

Part 2: Using ProKnow DS to Submit and Score Plans

Watch the video below for a walkthrough of how to use the ProKnow DS system and the standalone data anonymizer/uploader that we created with our API specifically for this study. Below the video, you will find the instructions written step-by-step to complement the video.

1. Log in to ProKnow DS for the first time.
   1. Navigate your supported browser (Windows: Chrome-Firefox | macOS: Chrome-Firefox) to varian.proknow.com.
   2. Follow these instructions to log in for the first time (section called “Resetting Your Password”).
   3. If you do not get the confirmation email to set/reset your password, you may not have registered yet and/or have not been added as a user by Varian managers. Contact Varian directly to remedy this.
2. Download the standalone data anonymizer/uploader application. To help facilitate participants’ uploading of patient data, we have used our API to create a standalone application that will first anonymize, then upload, the DICOM data you select.
   1. Click here to download the uploader application. This is an executable file that will run on Windows but will not require any installation. Note: If your browser gives you a warning about downloading an unknown application or one that is not commonly downloaded, just override the warning (e.g., if using Chrome, you will simply select “Keep” to download the file).
   2. Once downloaded, move the executable file to a folder location that you can keep unchanged for the 1-2 weeks that submissions are open.
3. Configure the anonymizer/uploader application. Note: You will only have to do this once.
   1. Log in to ProKnow DS as described above.
   2. Once logged in, go to the main ProKnow menu (the big “P” in upper left of application) and select “Your Profile.”
   3. Select “API Keys.”
   4. Enter a simple key name (we suggest you use “proknow-uploader”) and select the “Create” button.
   5. This will create a file called “credentials.json” that will be downloaded automatically. From your download directory, move (or copy) this file to the same folder where you saved the executable file.
   6. Run the uploader application by double-clicking the executable file. Note: If you get a Windows warning (e.g., “Windows protected your PC”) then click the “More info” link, then click the “Run Anyway” button.
   7. Browse for the credentials file that you just moved/saved. After you select it, you should see validation and three green check marks in that section of the application. When you see this, your configuration is complete and you are ready to upload patient data!
4. Using the anonymizer/uploader application.
   1. Once you find a good dataset and open your existing (or create a new) treatment plan in Eclipse, you will need to export the whole DICOM dataset (CT images, RT structure set, RT plan, and RT dose). Choose an export configuration that will create DICOM files as opposed to pushing to another device.
   2. Eclipse’s default behavior is to export all patient DICOM files to a common folder. To avoid file confusion, you will want to find the files you just created from Eclipse and move them to a dedicated folder of your choice.
   3. In the ProKnow uploader application, choose either “Select Directory” (to upload all files in that folder and all of its subfolders) or “Select Files” (if you want to select the files manually).
   4. After selecting the directory or files, the uploader will display a message that your files are being “scanned and anonymized.”
   5. After scanning and anonymization are complete, you will see a message that indicates that you are ready to upload. Specifically, you will see “Upload” and “Clear” buttons appear.
   6. Click “Upload.”
   7. Wait for the uploading to complete. This will be indicated by the disappearance of the displayed “Uploads are in progress …” info text and the enablement of the “View Patient in ProKnow DS” button.
   8. Click the “View Patient in ProKnow DS” button, which will open a browser tab for your patient dataset.
5. Review your plan scorecard.
   1. For details about the metrics and their objectives, please see “Part 3: Discussion of the Plan Scorecard” section below.
   2. ProKnow DS will render a scorecard for your plan, found on the “Scorecard” tab on the left of the screen.
   3. Your plan score will be displayed at the top. It should be shown out of a total max score of 150.0. Remember that it is not your absolute plan score that will determine the winner, but rather the difference between your plan’s score and the eventual RapidPlan’s absolute plan score.
6. Accounting for missing structures or structures that need to be renamed. If you see any scorecard rows with the yellow/warning triangle, it means you are either missing that structure or you need to simply rename an existing structure to match the standard scorecard name.
   1. If you plan to do more planning in Eclipse to optimize your score, you will want to create and/or rename your structures in Eclipse, then re-upload the new DICOM RT Structure Set.
   2. Alternatively, if you are done planning and only need to create, edit, or rename structures, you can use ProKnow’s contouring tools for that so that you complete all rows in the scorecard.
7. Uploading multiple iterations of your planning data. You can upload as many dataset iterations as you want in the allotted submission time. You will want to ptimize your plan score while maintaining a reasonable and safe plan.
   1. If you switch to a new patient dataset, then simply upload the entire dataset (CT, RTSS, RTP, and RTD) with the new data.
   2. If you have finalized your CT and RT Structure Set and are simply uploading new iterations of your RT Plan and RT Dose, you only need to upload those two files for each subsequent iteration.

Part 3: Discussion of the Plan Scorecard

Play the video below for a detailed discussion of the plan metrics and per-metric objectives for this esophageal case.

Support and Contact Info

For more information about using ProKnow DS, feel free to visit our user training website where you will find 40+ training topics and videos. Or, you can use our searchable online help site. If you cannot find an answer to your question, you can email support@proknow.com.

For questions about the event, its schedule, the rules, etc., you can send a message to Varian at speaktome@varian.com which will be forwarded to the pertinent people. If you need to register or have questions not answered after a query to the prior email address, please contact Karen at karen.kigin@varian.com.