The .decimal Astroid Planning App is used for treatment planning of proton radiation therapy treatments. The Astroid Planning App is an interactive end user application that leverages the existing .decimal Dosimetry App functions for device creation, dose calculation, and optimization to facilitate efficient development of proton radiation treatment plans.

The purpose of this document is to provide guidance on the setup, access, and usage of the Astroid Planning App.

The Instructions for Use outlines the general usage principles and limitations of the Astroid Planning App. Users must read and understand these instructions before operating the system for clinical use. Refer to each section below for complete details:

• Overview and Indications for Use
• User Responsibilities
• Warning
• User Profile
• Indications for Use
• Intended Use
• Product Features
  1. Function Access and Data Storage
  2. Proton Dose Calculations
  3. Proton Aperture Designs
  4. Proton Range Compensator Designs
  5. Patient Specific Data Model
  6. Proton Treatment Delivery Machine Model
• Data Model

It is the responsibility of those utilizing this application to ensure all that all usages of this product relating to patient treatments are performed by trained and qualified personnel only and that such personnel is aware that the quality of any generated treatment plans is highly dependent on the quality and correctness of the input data; therefore if any questions or uncertainties exist regarding the quality, units, or identification of input data arise, they must be investigated and resolved before the data are used.

Astroid utilizes keyboard shortcuts to help streamline many commonly used functions and display controls. A complete listing of these shortcuts along with a full description of the mouse controls is located at the Keyboard and Mouse Controls page.

The following task descriptions are thorough guides providing complete information about each task within the Astroid Planning Application.

• Launching the Astroid Planning App
• Uploading a DICOM Patient
• Importing Patient Data
• Courses, Intents, and Directives
• Patient Models
• Creating a Plan
  • Structures
  • Dose Grid
  • PBS Beams
    • Defining an Aperture
  • Fraction Groups
  • Defining Constraints
  • Setting Objectives
  • Astroid Optimization
    • Feasibility & Constraints
    • Running the Optimizer
    • Dose Normalization
    • Navigating the Solutions
  • Using the Plan History
  • Publishing a Plan

• More coming soon …

The following walkthroughs will take you through the process of creating complete treatment plans in the Astroid Planning App. They provide detailed steps so that any user can begin using the software. Each guide covers a specific type of treatment plan, and although some walkthroughs share certain steps, each has been written as a self-contained unit so that you may begin with whatever guide is the most useful.

• Prostate Plan Walkthrough

When using the Astroid Planning App, as with any complex program, there is the potential for misuse. The various Astroid Apps comprise a suite of radiotherapy treatment planning tools that are intended to be used by experienced and knowledgeable professionals working in the field of radiation therapy.

Below are listed the known application limitations, defects, or inconsistencies.

1. The Astroid Planning App is pre-510(k) at this time and has not been validated for use in actual patient treatments
2. When changing a structure type from a TARGET, whether at the Patient Model or Plan level, if that structure was an existing optimization constraint or objective with maximize options selected, those options will continue to be selected and will unable to be changed in the UI. They can be viewed in the optimization constraint and objective summaries, but will not be editable unless the structure type is changed back to TARGET.
   1. This can result in you having constraints or objectives that might not be ideal for this type of structure. Always double check the constraint/objective summaries if you need to change a structure type from TARGET after you've added optimization parameters to that structure.
3. When importing a new patient, the default physician will be set from the DICOM file. When this physician selection is changed, either during import or later in the Patient Overview, there is no way to re-select the original from DICOM physician.
4. Structures that are expanded in the axis of the CT image slices will have the expansion distance limited by the CT image spacing. So the expansion distance may appear to be an incorrect distance.
5. When creating a new target for a PBS beam via the Create subtask from the Geometric Target drop down, you are able to create a non target structure and have it be selected in this drop down. This is only possible when the Create subtask automatically populates the dropdown upon finishing, and you will not be able to select this target manually if you change the selection.
6. Astroid uses only IEC 61217 coordinate systems (i.e. machine based coordinate systems are NOT available at this time)

See Thinknode Errors for common problems that occur during usage of the Planning app.

Should you discover or suspect any additional errors or limitations not noted above, please contact the .decimal Astroid Planning App development lead, Kevin Erhart, at kerhart@dotdecimal.com with details of your concerns. All concerns will be addressed as quickly as possible and follow up with the submitter will occur throughout the inquiry and correction process.

The results API is provided to facilitate a controlled and consistent means for accessing necessary treatment plan details and information. The Results API is most frequently used by customers wishing to develop custom treatment plan reports for clinical patients. From the results API treatment plan data can be accessed, including (but not limited to): patient geometries, prescriptions, beam information, spot placements, and plan dose results. It should be pointed out that when users generate custom plan reports they must include an indication of the coordinate system in which any position information is being displayed and users should be reminded that all Results API position data is provided in IEC 61217 coordinate systems at this time.

Most Planning Results API functions must be called using Thinknode meta requests. Because of this added complexity, an example function call has been added for end user convenience.

For a comprehensive list of available Planning Results API functions, please refer to the Results API Function List.

In the .decimal astroid-script-library there is a script called planning_results_api_example.py that provides a basic example in calling and accessing the results API meta functions.

In this particular example the generate_plan_summary_request is the API function being called by the generator and meta function as this is a common function to use in extracting data for use in generating treatment plan reports.