Using ROE

Setup

1. Load CERR archive

Open up the CERR archive containing pre-defined structures and dose plan in the Viewer

Treatment plan, showing GTV, lung excluding GTV, and esophagus, with prescription dose scaled to 100

2. Specify paths to input JSON files

The path to sample protocols, models and criteria is used by default. This path may be modified to point to a different directory containing user-specified protocol/model/criteria files.

In CERROptions.json:

"ROEProtocolPath" : "your/path/to/protocolsDir", 
"ROEModelPath" : "your/path/to/modelsDir",
"ROECriteriaPath" : "your/path/to/criteriaDir"

Using the interface

1. Launch ROE by typing ROE into Matlab's Command window.

2. Click Select baseline fractionation to choose from the list of available fractionation schemes. All schemesavailable in "ROEProtocolPath" are listed.

3. Click on 'Baseline fractionations' [1] to display the list of available protocols. Select a fractionation scheme [2] to display the list of associated models and available dose plans.

4. Select from available dose plans [5].

5. Specify prescribed dose (Gy) for selected plan. [4] ROE scales the input dose array based on total dose for the selected fractionation and actual (prescribed) dose.

6. Click on each of the listed models [3] and select required structures [6].

7. Modify patient-specific model input parameters as needed [7].

8. Choose a display mode [8] and click Plot [9] to visualize the predicted outcomes.

• Display modes
  ROE supports 4 different display modes:

  • Plot NTCP vs. BED (only supported where JSON configuration for BED model is available in ROEModelPath)
  • Plot NTCP vs. TCP (only supported where JSON configuration for TCP model is available in ROEModelPath)
  • Scale fraction size : Plot outcomes as a function of fraction size. The x-axis represents fractional scale applied to original input fraction size (scale=1 corresponds to original protocol).
  • Scale fraction number: Plot outcomes as a function of fraction number. The x-axis represents difference in no. of fractions from the input protocol (change in fraction num=0 corresponds to original protocol).

• Examples

9. Verify structure selections from CERR archive vs. required NTCP/TCP/BED model inputs.

• Displaying clinical limits

ROE incorporates user-defined limits on NTCP and dose-volume constraints. The first operative clinical limit for each protocol is displayed by default, with an additional interface to view/hide selected constraints or to cycle through available constraints in their order of violation. These options are available under the Constraints tab of the GUI.

Expandable tool-tips provide information on the violated constraints, scaled fraction size or fraction number resulting in the violation, and the corresponding NTCP and tumor BED.

Demos

NSCLC patient