decimal App Documentation

This walk-through is intended to be an easy to follow step-by-step guide for completing a “standard clinical electron” set-up. It covers all steps involved in designing and ordering an electron aperture from .decimal. The intent is that after completing this walk-through you will have gained the knowledge and understanding necessary to complete a clinical electron set up utilizing the decimal3D App (it should be noted that the values provided herein are not intended to represent clinical guidelines and should in no way be considered a recommendation for values that are appropriate for clinical use).

1. Have the physician outline the desired treatment area on the patient's skin using a marker or pen with high color contrast
2. Bring the patient to the simulator or treatment room and place them in the desired treatment position
3. Open the decimal3D app on the iPad and login with your unique username and password . The username and password is the same as what is used to sign in to p.d.
4. Select New Patient in the top right hand of the Patient Management Screen
5. Enter the Patient Name
6. Enter the Date of Birth
7. Select the patient Gender from drop down
8. Enter the MRN (Medical Record Number)
9. If desired, enter the Physician name
10. Press Submit and the patient record will be created
11. In the top right hand corner select New Scan
12. Select the New Scan button on the left hand side
    1. Before starting the scan, you must orient the iPad to the treatment table so that couch and gantry angles can be accurately determined
    2. To perform this orientation, simply hold the iPad against the edge of the treatment table (with the gantry toward YOUR LEFT and the iPad parallel to the floor) and press the Align button as shown in the images below
    3. You are now ready to scan the patient. Focus the scanner on the area to be scanned. Adjust your distance from the patient to ensure the entire area to be scanned appears in RED (red indicates an ideal scan distance, yellow is slightly too far away, and if no color is shown, you are too close to the patient). The ideal distance is about half a meter (18 to 24 inches)
    4. The box shown in the app can also be adjusted to control the size of the area to be scanned. Only areas fully within the box will be captured during the scan, so you can use a two-finger pinch to shrink or expand the box as needed for the field size at hand.
    5. Once you are correctly positioned, press the Scan button to begin capturing data.
    6. While the scan is active, the area that has been fully captured will appear white. You should continue scanning until the entire desired area is shown in white. For relatively smooth or flat areas, the scan can be obtained within 1-2 seconds without moving the iPad, but for larger or highly curved areas, you may need to slowly move or rotate the iPad to capture the entire patient surface.
    7. Press the Scan button again to complete the scan.
       1. The decimal3D app now automatically begin processing the scan depth and color data to produce the colorized 3D model
13. Once the scan is done processing review the resulting model
    1. If the scan is acceptable select Accept Scan
    2. If it the scan is not acceptable select New Scan button on the left-hand side to discard this scan and start a new scan
14. Choose the desired treatment machine from the scroll selector and edit the name of the scan if desired (by default scans are labeled with sequential numbers, e.g. Scan 1). Scan names are used only for convenience to locate scans within a patient and are not used for any other purpose in the application. Press Submit when done.
15. Your scan is now complete and saved and you are ready to digitize the treatment field
16. Select Contours
17. Using either the Apple Pencil or a finger dwell on the scanned image for a second and begin to digitize the area to be treated. The traced area will now show up in green.
18. Once the user has completed the digitizing they may adjust the contour by selecting Adjust Contour. To do this the user needs to place the Apple Pencil or finger close to the area that needs to be adjusted and slide it to where it should be
19. If the user is satisfied with select the Finish option on the right hand side of the screen. The user can now name the contour or leave the name at the default. Choose Submit when done
20. To create the beam user must first select contour they want to place the beam on and then select the orange Next in the bottom left of the screen
21. The user can then rotate the patient and then will tap on the scan where they want to place the entry point and select the orange Next
22. The user can then adjust any of the parameters they want to to achieve a better fit
23. The user may also rotate to ensure that there is no collision
24. If the user is satisfied they may hit the orange Save button
25. At this point the user may proceed to ordering the cutout but choosing Order in the top right hand corner
26. The user must select the shipping priority. Once this is done they may select Done and the information will be securely sent to .decimal and the cutout manufactured