Ongoing development of digital radiotherapy plan review tools

Full text: To describe ongoing development of software to support the review of radiotherapy treatment planning system (TPS) data. The 'SWAN' software program was conceived in 2000 and initially developed for the RADAR (TROG 03.04) prostate radiotherapy trial. Validation of the SWAN program has been occurring via implementation by TROG in support of multiple clinical trials. Development has continued and the SWAN software program is now supported by modular components which comprise the 'SW AN system'. This provides a comprehensive set of tools for the review, analysis and archive of TPS exports. The SWAN system has now been used in support of over 20 radiotherapy trials and to review the plans of over 2,000 trial participants. The use of the system for the RADAR trial is now culminating in the derivation of dose-outcomes indices for prostate treatment toxicity. Newly developed SWAN tools include enhanced remote data archive/retrieval, display of dose in both relative and absolute modes, and interfacing to a Matlab-based add-on ('VAST') that allows quantitative analysis of delineated volumes including regional overlap statistics for multi-observer studies. Efforts are continuing to develop the SWAN system in the context of international collaboration aimed at harmonising the quality-assurance activities of collaborative trials groups. Tools such as the SWAN system are essential for ensuring the collection of accurate and reliable evidence to guide future radiotherapy treatments. One of the principal challenges of developing such a tool is establishing a development path that will ensure its validity and applicability well into the future.