Developing a web‐based dashboard for adaptive radiotherapy workflows

PURPOSE: Adaptive radiotherapy (ART) is limited by the absence of reliable thresholds to trigger necessary plan adaptation. This work develops and verifies a web-based, database-backed dashboard that unifies geometric, dosimetric, and radiobiological metrics to support day-to-day ART decisions. METHODS: Ten retrospectively selected patients were analyzed (Head and Neck (H&N), n = 5, 30-35 fx; prostate MR-linac, n = 5, 5 fx). Daily dose was recalculated on CBCT-derived pseudo-CTs (pCT) (H&N) or on daily MR images (prostate). A Python/Dash dashboard with a PostgreSQL backend takes in RTStruct/RTDose, then performs structure name harmonization, computes per-fraction DVHs, and derives five radar-chart metrics: organ central point displacement, interfraction Dice (reported as 1-Dice), intrafraction Dice (OAR-PTV overlap vs reference), objective score (deviation from plan objectives), and a radiobiology score using TCP/NTCP to calculate PI, PB, and P+. Residuals, defined as the difference between the reference metric (MIM) and the corresponding dashboard calculated value (MIM-Dashboard), were calculated to assess agreement. Calculations were verified against MIM Maestro using residual plots, paired t-tests (α = 0.05), and effect sizes. RESULTS: ). Radiobiology residuals were modest (mean: PI +1.78%, P+ -1.11%, PB +0.86%) with occasional outliers (max PI 8.69%). Three metrics reached statistical significance (central point, intra-/inter-fraction Dice), but effect sizes were negligible to small. CONCLUSIONS: The dashboard reproduces geometric, DVH, objective, and radiobiology metrics within acceptable limits relative to MIM, providing a credible foundation for ART decision support. Limitations include the projected DVH being a visualization (not dose accumulation) and radiobiology sensitivity to DVH sampling in steep gradients.

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Publication Details

Journal
Journal of Applied Clinical Medical Physics
Published
2026-04-01
DOI
https://doi.org/10.1002/acm2.70546
Primary Topic
Advanced Radiotherapy Techniques
Type
article
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article

Developing a web‐based dashboard for adaptive radiotherapy workflows

Ara Alexandrian, Chloe DiTusa, Panayiotis Mavroidis, Christopher W. Schneider et al.
Journal of Applied Clinical Medical Physics
Advanced Radiotherapy Techniques
article

Developing a web‐based dashboard for adaptive radiotherapy workflows

Ara Alexandrian, Chloe DiTusa, Panayiotis Mavroidis, Christopher W. Schneider, Michael Allen, Sotiri Stathakis, Emma Sargent
article en

Abstract

PURPOSE: Adaptive radiotherapy (ART) is limited by the absence of reliable thresholds to trigger necessary plan adaptation. This work develops and verifies a web-based, database-backed dashboard that unifies geometric, dosimetric, and radiobiological metrics to support day-to-day ART decisions. METHODS: Ten retrospectively selected patients were analyzed (Head and Neck (H&N), n = 5, 30-35 fx; prostate MR-linac, n = 5, 5 fx). Daily dose was recalculated on CBCT-derived pseudo-CTs (pCT) (H&N) or on daily MR images (prostate). A Python/Dash dashboard with a PostgreSQL backend takes in RTStruct/RTDose, then performs structure name harmonization, computes per-fraction DVHs, and derives five radar-chart metrics: organ central point displacement, interfraction Dice (reported as 1-Dice), intrafraction Dice (OAR-PTV overlap vs reference), objective score (deviation from plan objectives), and a radiobiology score using TCP/NTCP to calculate PI, PB, and P+. Residuals, defined as the difference between the reference metric (MIM) and the corresponding dashboard calculated value (MIM-Dashboard), were calculated to assess agreement. Calculations were verified against MIM Maestro using residual plots, paired t-tests (α = 0.05), and effect sizes. RESULTS: ). Radiobiology residuals were modest (mean: PI +1.78%, P+ -1.11%, PB +0.86%) with occasional outliers (max PI 8.69%). Three metrics reached statistical significance (central point, intra-/inter-fraction Dice), but effect sizes were negligible to small. CONCLUSIONS: The dashboard reproduces geometric, DVH, objective, and radiobiology metrics within acceptable limits relative to MIM, providing a credible foundation for ART decision support. Limitations include the projected DVH being a visualization (not dose accumulation) and radiobiology sensitivity to DVH sampling in steep gradients.

Journal of Applied Clinical Medical PhysicsVol. 27(4)
University of North Carolina at Chapel Hill (US), Louisiana State University (US), Mary Bird Perkins Cancer Center (US)
Openalex Percentile: Top 21%
Advanced Radiotherapy Techniques
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