Open RT Structures: A Solution for TG-263 Accessibility.

BACKGROUND: Consistency of nomenclature within radiation oncology is increasingly important as big data efforts and data sharing become more feasible. Automation of radiation oncology workflows depends on standardized contour nomenclature which enables toxicity and outcomes research, while also reducing medical errors and facilitating quality improvement activities. Recommendations for standardized nomenclature have been published in the American Association of Physicists in Medicine (AAPM) report from Task Group 263. Transitioning to TG-263 requires creation and management of structure template libraries and retraining of staff, which can be a considerable burden on clinical resources. Our aim is to develop a program that allows users to create TG-263 compliant structure templates in English, Spanish, or French to facilitate data sharing.

METHODS: 53 pre-made structure templates were arranged by treated organ based on an American Society for Radiation Oncology (ASTRO) consensus paper. Templates were further customized with common target structures, relevant OARs (e.g., Spleen for anatomically relevant sites such as gastroesophageal junction or stomach), sub-site specific templates (e.g. partial breast, whole breast, intact prostate, postoperative prostate, etc.) and brachytherapy templates. An informal consensus on OAR and target coloration was also achieved, though color selections are fully customizable within the program.

RESULTS: The resulting program is usable on any Windows system and generates template files in practice-specific DICOM or XML formats, extracting standardized structure nomenclature from an online database maintained by members of the TG-263U1 Task Group which ensures continuous access to up-to-date templates.

CONCLUSIONS: We have developed a tool to easily create and name DICOM-RT structures sets that are TG-263-compliant for all planning systems utilizing the DICOM standard. The program and source code are publicly available via GitHub, encouraging feedback from community users for improvement and guide further development.