Patent Publication Number: US-2007104316-A1

Title: System and method of recommending a location for radiation therapy treatment

Description:
RELATED APPLICATIONS  
      This application claims the benefit of U.S. Provisional Patent Application No. 60/701,544; filed on Jul. 22, 2005; entitled SYSTEMS AND METHODS OF REMOTELY ACCESSING A RADIATION THERAPY TREATMENT SYSTEM; the entire content of which is incorporated herein by reference. 
    
    
     BACKGROUND  
      Over the past decades, improvements in computers and networking, radiation therapy treatment planning software, and medical imaging modalities have been incorporated into radiation therapy practice.  
     SUMMARY  
      There are many clinical processes, both for patient treatment and system quality assurance/maintenance that would benefit from remote technologies.  
      In one embodiment, the invention proves a method of selecting a location for radiation therapy treatment. The method comprises the acts of receiving patient information, compiling an electronic patient profile; communicating the profile to a plurality of treatment planning locations, and generating at least one radiation therapy treatment plan from at least one of the plurality of treatment planning locations.  
      In another embodiment, the invention proves a method of recommending radiation therapy treatment for a patient. The method comprises the acts of receiving first throughput data from a first health-care facility, receiving second throughput data from a second health-care facility, receiving a patient profile, analyzing the first throughput data, the second throughput data and the patient profile, and recommending a health-care facility to schedule radiation therapy treatment for the patient based on the analysis.  
      In another embodiment, the invention provides a system for recommending radiation therapy treatment for a patient. The system comprises a computer processor, and a software program stored in a computer readable medium accessible by the computer processor. The software program is executable by the computer processor to receive first throughput data from a first health-care facility, receive second throughput data from a second health-care facility, receiving a patient profile, analyze the first throughput data, the second throughput data and the patient profile, and recommend a health-care facility to schedule radiation therapy treatment for the patient based on the analysis.  
      Other aspects of the invention will become apparent by consideration of the detailed description and accompanying drawings. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       FIG. 1  is a partial perspective view, partial schematic illustration of a radiation therapy system.  
       FIG. 2  is a schematic illustration of the radiation therapy system of  FIG. 1 .  
       FIG. 3  is a schematic illustration of a network for remote access to the radiation therapy system of  FIG. 1   
       FIG. 4  is block diagram of a software program that can be used in the radiation therapy system of  FIG. 1  or a remote computer of  FIG. 3 .  
       FIG. 5  is a block diagram of a software program that can be used in the remote computer of  FIG. 3 .  
       FIG. 6  is a flow chart illustrating a method of operation of the software programs of  FIGS. 4 and 5  according to one embodiment of the invention.  
       FIG. 7  is a flow chart illustrating a method of operation of the software programs of  FIGS. 4 and 5  according to one embodiment of the invention.  
       FIG. 8  is a flow chart illustrating a method of operation of the software programs of  FIGS. 4 and 5  according to one embodiment of the invention.  
       FIG. 9  is a flow chart illustrating a method of operation of the software programs of  FIGS. 4 and 5  according to one embodiment of the invention.  
       FIG. 10  is a flow chart illustrating a method of operation of the software programs of  FIGS. 4 and 5  according to one embodiment of the invention. 
    
    
     DETAILED DESCRIPTION  
      Before any embodiments of the invention are explained in detail, it is to be understood that the invention is not limited in its application to the details of construction and the arrangement of components set forth in the following description or illustrated in the following drawings. The invention is capable of other embodiments and of being practiced or of being carried out in various ways. Also, it is to be understood that the phraseology and terminology used herein is for the purpose of description and should not be regarded as limiting. The use of “including,” “comprising,” or “having” and variations thereof herein is meant to encompass the items listed thereafter and equivalents thereof as well as additional items. Unless specified or limited otherwise, the terms “mounted,” “connected,” “supported,” and “coupled” and variations thereof are used broadly and encompass both direct and indirect mountings, connections, supports, and couplings. Further, “connected” and “coupled” are not restricted to physical or mechanical connections or couplings.  
      Although directional references, such as upper, lower, downward, upward, rearward, bottom, front, rear, etc., may be made herein in describing the drawings, these references are made relative to the drawings (as normally viewed) for convenience. These directions are not intended to be taken literally or limit the invention in any form. In addition, terms such as “first”, “second”, and “third” are used herein for purposes of description and are not intended to indicate or imply relative importance or significance.  
      In addition, it should be understood that embodiments of the invention include hardware, software, and electronic components or modules that, for purposes of discussion, may be illustrated and described as if the majority of the components were implemented solely in hardware. However, one of ordinary skill in the art, and based on a reading of this detailed description, would recognize that, in at least one embodiment, the electronic based aspects of the invention may be implemented in software. As such, it should be noted that a plurality of hardware and software based devices, as well as a plurality of different structural components may be utilized to implement the invention. Furthermore, and as described in subsequent paragraphs, the specific mechanical configurations illustrated in the drawings are intended to exemplify embodiments of the invention and that other alternative mechanical configurations are possible.  
       FIGS. 1 and 2  illustrate one construction of a radiation therapy system  10  that can provide radiation therapy to a patient  14 . The radiation therapy treatment can include photon-based radiation therapy, brachytherapy, electron beam therapy, proton, neutron, or particle therapy, or other types of treatment therapy. The radiation therapy system  10  includes a radiation therapy device  18  having a gantry  22 . Though the gantry  22  shown in the drawings is a ring gantry, i.e., it extends through a full 360° arc to create a complete ring or circle, other types of mounting arrangements may also be employed. For example, a C-type, partial ring gantry, or robotic arm could be used.  
      The gantry  22  can support a radiation module  26 , having a radiation source and a linear accelerator (collectively shown as  30 ) operable to generate a beam  34  of photon radiation. The radiation module  26  can also include a modulation device  38  operable to modify or modulate the radiation beam  34 . The modulation device  38  provides the modulation of the radiation beam  34  and directs the radiation beam  34  toward the patient  14 . Specifically, the radiation beam  30  is directed toward a portion of the patient. Broadly speaking, the portion may include the entire body, but is generally smaller than the entire body and can be defined by a two-dimensional area and/or a three-dimensional volume. A portion desired to receive the radiation, which may be referred to as a target or target region (shown as  42 ), is an example of a region of interest. Another type of region of interest is a region at risk. If a portion includes a region at risk, the radiation beam is preferably diverted from the region at risk. The patient  14  may have more than one target region  42  that needs to receive radiation therapy. Such modulation is sometimes referred to as intensity modulated radiation therapy (“IMRT”).  
      Other frameworks capable of positioning the radiation module at various rotational and/or axial positions relative to the patient  14  may also be employed. In addition, the radiation module  26  may travel in path that does not follow the shape of the gantry  22 . For example, the radiation may travel in a non-circular path even though the illustrated gantry  2  is generally circular-shaped.  
      The radiation therapy device  18  can also include a detector  46 , e.g., a kilovoltage or a megavoltage detector, operable to receive a radiation beam from the treatment radiation source or from a separate radiation source. The linear accelerator and the detector  46  can also operate as a computed tomography (CT) system to generate CT images of the patient  14 .  
      The CT images can be acquired with a radiation beam  34  that has a fan-shaped geometry, a multi-slice geometry or a cone-beam geometry. In addition, the CT images can be acquired with the linear accelerator  30  delivering megavoltage energies or kilovoltage energies.  
      The radiation therapy treatment system  10  can also include a patient support, such as a couch  54  (illustrated in  FIG. 1 ), which supports the patient  14 . The couch  54  moves along at least one axis in the x, y, or z directions. In other constructions, the patient support can be a device that is adapted to support any portion of the patient&#39;s body, and is not limited to having to support the entire patient&#39;s body. The system  10  also can include a drive system  58  operable to manipulate the position of the couch  54 . The drive system  58  can be controlled by the computer  50 .  
      As used herein, the term “computer” is broadly construed as an electronic device that receives, processes, and/or transmits information according to instructions. As used herein, the term “information” is broadly construed to include signals or data. The computer  50 , illustrated in  FIG. 2 , includes an operating system for running various software programs and/or communication applications. In particular, the computer  50  can include a software program  62  operable to communicate with the radiation therapy device  18 . The computer  50  can include any suitable input/output device adapted to be accessed by medical personnel. The computer  50  can include typical hardware such as a processor, I/O interfaces, and storage devices or memory. The computer  50  can also include input devices such as a keyboard and a mouse. The computer  50  can further include standard output devices, such as a monitor. In addition, the computer  50  can include peripherals, such as a printer and a scanner.  
      The radiation therapy device  18  communicates directly with the computer  50  and/or via a network  66  as illustrated in  FIG. 2 . The radiation therapy device  18  also can communicate with other radiation therapy devices  18  via the network  66 . Likewise, the computer  50  of each radiation therapy device  18  can communicate with a computer  50  of another radiation therapy device  18 . The computers  50  and radiation therapy devices  18  can also communicate with a database  70  and a server  74 . A plurality of databases  70  and servers  74  can also communicate with the network  66 . It is noted that the software program  62  could also reside on the server  74 .  
      The network  66  can be built according to any networking technology or topology or combinations of technologies and topologies and can include multiple sub-networks. Connections between the computers  50  and devices  18  shown in  FIG. 2  can be made through local area networks (“LANs”), wireless area networks (“WLANs”), wide area networks (“WANs”), public switched telephone networks (“PSTNs”), Intranets, the Internet, or any other suitable networks. In a hospital or medical care facility (collectively referred to as a health-care facility), communication between the computers  50  and devices  18  shown in  FIG. 2  can be made through the Health Level Seven (“HL7”) protocol with any version and/or other required protocol. HL7 is a standard protocol that specifies the implementation of interfaces between two computer applications (sender and receiver) from different vendors for electronic data exchange in health care environments. HL7 can allow health care institutions to exchange key sets of data from different application systems. Specifically, HL7 can define the data to be exchanged, the timing of the interchange, and the communication of errors to the application. The formats are generally generic in nature and can be configured to meet the needs of the applications involved.  
      Communication between the computers  50  and radiation therapy devices  18  shown in  FIG. 2  can also occur through the Digital Imaging and Communications in Medicine (DICOM) protocol with any version and/or other required protocol. DICOM is an international communications standard developed by the National Electrical Manufacturers Association (NEMA) that defines the format used to transfer medical image-related data between different pieces of medical equipment. DICOM RT refers to the standards that are specific to radiation therapy data.  
      The two-way arrows in the drawings generally represent two-way communication and information transfer between the network  66  and any one of the computers  50 , the radiation therapy devices  18 , and other components shown in the drawings. However, for some medical equipment, only one-way communication and information transfer may be necessary.  
       FIG. 3  schematically illustrates a radiation therapy system  10  that can be accessed by a remote computer  78  via a network  82 . The remote computer  78  can be a handheld device, such as a PDA or tablet PC. The remote computer  78  can access the radiation therapy system  10 , which is distinct from the remote computer  78 . Before proceeding further, it should be understood that the remote computer  78  may or may not be located in the same facility as the radiation therapy system  10  (or the image acquisition device  90 ), and the computer  50  may or may not be located in the same room as the radiation therapy device  18 . It is conceivable, for example, that the computer  50  not be proximate to the radiation therapy device  18 , the remote computer  78  to be located in the same facility as the radiation therapy system  10 , but that the remote computer  78  be distinct from the radiation therapy system  10  (including the computer  50 ).  
      The remote computer  78  includes an operating system for running various software programs and/or communication applications. In particular, the remote computer  78  can include a software program  86  operable to communicate with the radiation therapy system  10 , the network  82 , and other software for remote applications and communications. The remote computer  78  can include any suitable input/output device adapted to be accessed by medical personnel. The remote computer  78  can include hardware such as a processor, I/O interfaces, and storage devices or memory. The remote computer  78  can also include input devices such as a keyboard and a mouse, touch screen monitor. The remote computer  78  can further include standard output devices, such as a monitor. In addition, the remote computer  78  can include peripherals, such as a printer and/or a scanner.  
      The remote computer  78  enables medical personnel and technicians access to the radiation therapy system  10  while being on the move or in process of changing locations. As one example, medical personnel can view patient treatment history as well as edit and approve patient treatment plans without being at the site of the radiation therapy system  10 . Medical personnel also can generate, view, and edit contours, which are generated to identify the regions of interest in the CT images of the patient  14  and the target  42 . The contours also define the boundaries and the amount of radiation that a specific area or space of the target  42  will receive. Medical personnel also can approve or modify the treatment plan for a patient while at a remote location. The remote computer  78  provides a tool for medical personnel to manage patient and treatment information while providing mobility and convenience to the medical personnel.  
      The network  82  can be built according to any networking technology or topology or combinations of technologies and topologies and can include multiple sub-networks. Connections between the remote computers  78  and radiation therapy systems  10  shown in  FIG. 3  can be made through local area networks (“LANs”), wireless area networks (“WLANs”), wide area networks (“WANs”), public switched telephone networks (“PSTNs”), intranets, the Internet, or any other suitable networks. In a hospital or medical care facility, communication between the remote computers  78  and radiation therapy systems  10  shown in  FIG. 3  can be made through the Health Level Seven (“HL7”) protocol with any version and/or other required protocol. HL7 is a standard protocol that specifies the implementation of interfaces between two computer applications (sender and receiver) from different vendors for electronic data exchange in health care environments. HL7 can allow health care institutions to exchange key sets of data from different application systems. Specifically, HL7 can define the data to be exchanged, the timing of the interchange, and the communication of errors to the application. The formats are generally generic in nature and can be configured to meet the needs of the applications involved.  
      Communication between the remote computers  78  and the radiation therapy systems  10  shown in  FIG. 3  can also occur through the Digital Imaging and Communications in Medicine (DICOM) protocol with any version and/or other required protocol. DICOM is an international communications standard developed by NEMA that defines the format used to transfer medical image-related data between different pieces of medical equipment. DICOM RT refers to the standards that are specific to radiation therapy data.  
      Communication can also occur through remote access to the computer interface and/or through a web-type interface (e.g., java, html, etc.) Communication can also occur through images of the relevant data such as a screen image of a plan viewed over the web without having to actually commandeer the planning computer.  
      The radiation therapy system  10  can communicate with and import and export data from one or more image acquisition devices  90 , as illustrated in  FIG. 3 . In addition, the remote computers  78  can communicate with the image acquisition device  90 .  
      The two-way arrows in  FIG. 3  generally represent two-way communication and information transfer between the network  82  and any one of the remote computers  78 , the radiation therapy systems  10 , and other components shown in  FIG. 3 . However, for some medical equipment, only one-way communication and information transfer may be necessary. It should also be understood that the communication of information can be via a transmission or delivery of information and/or can be via making the information available (e.g., at a web site) for acquisition.  
      One exemplary software program  62  is schematically illustrated in  FIG. 4 . The software program  62  can be accessed remotely by the remote computer  78  and software program  86 . The remote computer  78  communicates with the network  82  and the radiation therapy system  10  (computer  50  and/or radiation therapy device  18 ).  
      It is noted that various components and modules are discussed below with respect to the software program  62 , however some or all of the components and modules could also be implemented in the software program  86 . It is also noted that the processing activities could occur at either the computer  50 , remote computer  78 , and/or server  74 . One particular benefit of remote processing of data is the opportunity for improved speed.  
      The software program  62  includes a system setup module  94  operable to configure the radiation therapy device  18 . The system setup module  94  is also operable to determine whether the device  18  is properly commissioned, that the output and geometry of the modulation device  38  and imaging system are correctly modeled and within predetermined tolerances, and that the device  18  is ready for patient use. The system setup module  94  can also conduct predefined commissioning steps of the device  18 , such as measurements of output, alignment, profiles, stability, geometry, couch performance, modulation device motion, gantry positioning/motion, and other device parameters.  
      The software program  62  also includes a quality assurance module  98  operable to conduct various tests and analyze the status and performance of the device  18 . The quality assurance module  98  includes a test module  102  operable to conduct various tests on the device  18 , such as radiation measurements, to verify proper operation. The personnel local to the radiation therapy device  18  (also referred to as the on-site personnel) can inform the remote site when to conduct tests and the types of tests to be conducted. Some of the tests may require that local personnel or a physicist perform a set of predefined preparatory steps, such as setting up jigs and phantoms, placing films, ion chambers, or other radiation measurement devices. These preparatory steps can be done by the local personnel before leaving for the evening or at other times when the device  18  is not being used. Other tests may require some local assistance, such as developing films or modifying setups.  
      The test module  102  is also operable to acquire and save data that is generated by performance of the tests. The test module  102  can retrieve patient specific data, such as data related to the delivery of a patient&#39;s treatment plan or future patient treatment plans, stored in the device  18  and/or computer  50 .  
      The quality assurance module  98  also includes an analysis module  106  operable to analyze the data acquired from the tests that were conducted by the test module  102  and the patient specific data. The analysis module  106  evaluates the test results to determine if the device  18  is within predefined tolerances and otherwise in proper operational condition. The analysis module  106  can compare the test results of the device  18  to previous test results from the same device  18  and/or to test results from other radiation therapy devices  18 . The analysis module  106  can evaluate delivery parameters of a treatment plan to determine if the device  18  delivered the treatment plan as expected. The analysis module  106  can also compare delivery parameters of more than one treatment plan of the same patient or different patients to determine if the device  18  delivered the treatment plan as expected. In some instances, the data results may help identify if the device  18  needs tuning and/or maintenance. The analysis module  106  can evaluate future patient treatment plans to verify that the plan and its associated device setup is suitable for delivery.  
      The analysis module  106  can specify whether local personnel need to take remedial action and/or identify whether additional tests or calibration should be performed on the device  18  if the analysis module  106  identifies an anomaly with the device  18  based on the test results. The analysis module  106  can also recommend changes to future patient treatment plans to compensate for changes that may be made to the device  18  as a result of retuning and/or maintenance.  
      The system setup module  94  and the quality assurance module  98  can improve the physics and quality assurance processes by offering consistency, automation, and efficiency. The features provided by the system setup module  94  and the quality assurance module  98  can be implemented in medical clinics (or elsewhere) that wish to save time in conducting the quality assurance processes for the device  18 . The features offered by the modules  94  and  98  allow a medical clinic to receive oversight and training when beginning to use the device  18 .  
      Medical personnel, at the remote computer  78 , can instruct the test module  102  to perform a specified test of the device  18 . The medical personnel, again from the remote computer  78 , can instruct the analysis module  106  to evaluate the test results. Alternatively, the analysis module  106  can automatically analyze the test results. The analysis module  106  can transmit a report of the analysis results and/or recommendations to the remote computer  78  for review by the medical personnel.  
      The software program  62  also includes a training module  110  operable to monitor operation of the device  18  as medical personnel learn to operate and interact with the device  18 . The training module  110  can provide step-by-step instructions for setup of the device  18  for quality assurance tests and/or for patient use. For example, the remote computer  78  can instruct the training module  110  to operate the device  18  and conduct various tests and/or operate according to a treatment plan while the medical personnel observes. Also, the training module  110  allows personnel at the remote computer  78  to monitor medical personnel as they operate the device  18 . Personnel at the remote computer  78  can provide suggestions and advice to the local personnel on how to operate the device  18 . Similarly, personnel at the remote computer  78  can monitor or supervise the local personnel during patient treatments. Training of medical personnel can be performed through the network  82  using the remote computer  78  to operate the training module  110  and radiation therapy device  18 , and deliver instructions to trainees in real-time.  
      The software program  62  also includes a service module  114  operable to monitor component performance and reliability and environmental factors of the radiation therapy device  18 . The service module  114  includes a monitoring module  118  operable to monitor enviromnental factors such as temperature, humidity, and air pressure of the room in which the device  18  is located. The monitoring module  118  is also operable to monitor parameters of the device  18 , such as water flow, internal temperature, internal pressure, and the like. The monitoring module  118  can also monitor performance of external components, such as ion chambers, water tanks, diodes, film/film processors and the like. The monitoring module  118  can monitor in real-time the environmental factors, the device parameters, and the external components as the device  18  is in operation.  
      The service module  114  also includes a tracking module  122  operable to record and track the parameter data of the monitoring module  118 . The tracking module  122  can compare the monitored parameter data to historical parameter data to identify device component problems. For example, the tracking module can compare recent parameter data relating to the beam of radiation from the radiation module  30  with historical parameter data relating to the beam of radiation from the radiation module  30 . The tracking module  122  can automatically generate a report when a device component problem is identified and transmit the report to the remote computer  78 . The tracking module  122  can generate a notification via phone, electronic mail, beeper, system messaging, or other modes of communication based on the type of component problem identified. In addition, the remote computer  78  can access the tracking module  122  to review the status of the parameter data to identify risk factors that indicate unsafe treatments to reduced machine stability to component failure. The remote computer  78  can instruct the service module  114  to correct the identified problem. For example, the remote computer  78  can instruct the service module  114  to retune or realign the device  18 , change the room temperature, and schedule a component replacement.  
      The software program  62  also includes a treatment module  126  operable to perform functions related to patient treatment plans. There are numerous stages of the radiation therapy treatment process in which a clinical decision (or revision), approval, or judgment is necessary (collectively referred to as a decision point). Medical personnel interact with the treatment module  126  via the remote computer  78  to oversee multiple patients  14 , treatment plans, and/or devices  18 .  
      The treatment module  126  is operable to receive instructions from the remote computer  78 , which allows medical personnel to view, edit, and/or approve patient plan optimization; view, edit, and/or approve patient contours; view, edit, and/or approve patient registration, and registration histories for a patient  14 ; view, edit, and/or approve adaptive therapy; view, edit, and/or approve quality assurance functions; view device history; view user history; view patient history; contact service/schedule maintenance; view data for other devices  18  or clinics; and transfer and/or triage patients to other devices  18  or clinics.  
      The treatment module  126  can include a contouring module  130  operable to generate contours on an image, such as a planning image. The contouring process is time consuming and may be outsourced to a remote center or to an automated system. The remote computer  78  can receive notification from the treatment module  126  that a treatment plan is waiting for the contours to be identified. The contouring task can be performed by trained and qualified personnel at the remote center. The local medical personnel can then approve, edit, or reject the remotely performed work, which in many cases could be done more efficiently. Alternatively, medical personnel can access the contouring module  130 , via the remote computer  78 , to view, edit, and/or approve the contours of a patient treatment plan.  
      The treatment module  126  also includes a dose module  134  operable to acquire patient radiation dose information after a treatment plan is delivered. The dose module  134  is operable to recalculate dose and/or perform deformation after each fraction based upon recent patient images, treatment parameters, and treatment feedback information, such as exit dose. The dose module  134  can process and analyze the dose data in accordance with specified tolerances. The dose module  134  can automatically transmit the data and analyzed results to the remote computer  78  for review. Medical personnel can review the dose data at the remote computer  78  and transmit suggestions back to the dose module  134  to make adjustments or determine whether the treatment is progressing according to the plan. The local personnel can review the suggestions made by the remote personnel and approve, alter, or reject the suggestions. The suggestions of the remote personnel could automatically be implemented if the local personnel provide a pre-approval for all suggestions, a sub-set of the suggestions, or changes that would fall within a predefined range made by the remote personnel.  
      The treatment module  126  also includes a monitoring module  138  operable to monitor all aspects of a treatment. The monitoring module  138  can include the use of video cameras that monitor the patient  14  and local medical personnel and windows into the device  18  and computer  50  that operate the device  18 . The remote computer  78  can access the monitoring module  138  to monitor all aspects of radiation treatment from a remote location. The monitoring module  138  can be used for training, additional safety, or more efficiency. The remote computer  78  can access the monitoring module  138  such that remote medical personnel can view and/or adjust a treatment (e.g., positional parameters for gating, ultra sound, implantable markers, camera based tracking, detector data, and spirometric data) either in real-time or post-treatment. The monitoring module  138  can receive instructions from the remote computer  78  to adjust/discontinue treatment if certain tolerances are exceeded and/or predetermined protocols are not followed. The monitoring module  138  can generate a report or a notification to the remote computer  78  if certain tolerances are exceeded during treatment, or to indicate that treatment or a phase of treatment has been completed. Personnel at the remote computer  78  can notify other specified parties by phone, paging, electronic mail, or other modes of communication. Alternatively, the monitoring module  138  can notify other specified parties by phone, paging, electronic mail, or other modes of communication.  
      The software program  86  is schematically illustrated in  FIG. 5 . The software program  86  includes a medical center data module  142  operable to acquire and analyze throughput from a plurality of medical centers having radiation therapy systems  10 . The medical center data module  142  can communicate with the computer  50  and the radiation therapy device  18  to retrieve data. The medical center data module  142  can organize and evaluate clinical throughputs on both a macroscopic (# of patients per day, etc.) level and a microscopic (speeds and delays related to particular steps of the treatment process) level. The medical center data module  142  can compare speeds for particular clinicians, treatment types, medical centers, etc. The medical center data module  142  can present options for improving medical center efficiency. For example, the medical center data module  142  could identify ways in which the slower medical centers or persons could improve, while also indicating how the radiation therapy system  10  could be improved based upon use. It could also allow for comparison of treatment plans, delivery times, opportunities for combined therapy, and outcomes with other centers.  
      The medical center data module  142  could facilitate scheduling for one or more medical centers by evaluating the speeds and workloads of the centers, along with the current patient load, machine downtime, patient distances to the different medical centers, and other information. Less tangible factors, such as patient willingness/unwillingness to travel, preference for particular clinical personnel, or interest in faster/slower fractionation schedules could also be incorporated. This queuing of patients could be performed for a single medical center or for a plurality of medical centers. Additional functionality can include the conversion of plans for running on different radiation therapy treatment devices  18 , automated QA and physics necessary to run plans at different medical centers, remote adaptive therapy to monitor deliveries, accumulate dose, and adjust plans as needed, notification of relevant personnel, and remote consultation with primary clinicians.  
      The software program  86  also includes a plan conversion module  146  operable to convert treatment plans generated by different radiation therapy system manufacturers. The plan conversion module  146  can also convert treatment plans generated by radiation therapy systems  10  at different medical centers. The plan conversion module  146  analyzes the treatment plan and system settings generated by a radiation therapy system  10  of a first manufacturer to generate a treatment plan and system settings for a radiation therapy system  10  of a second manufacturer. Some factors that may be considered during the conversion process are the type of linear accelerator of the system, whether the couch or patient support is movable, whether a ring-type gantry or a C-arm is utilized, how a tumor is defined, and how dose is determined.  
      The software program  86  also includes a plan comparison module  150  illustrated in  FIG. 5 . The plan comparison module  150  is operable to compare treatment plans and assist the patient  14  in comparing and shopping for radiation therapy treatment. The patient  14  may elect to have pre-treatment (or mid-treatment or even post-treatment) data sent to a set of medical centers interested in generating potential treatment plans. The plan comparison module  150  can receive and transmit the patient data to a plurality of facilities for plan generation. The plan comparison module  150  can receive the generated plans and compare the different plans, the locations where treatment will be administered, treatment quality, side-effects, personnel on site, and other parameters and make a recommendation to the patient  14  based on certain requirements set forth by the patient  14 . The patient  14  can then enlist in treatment at a preferred medical center. A planning center does not need to perform the treatment itself, as another option is for a remote planning center to export the plan to a local center where the treatment can be delivered.  
      Alternatively, the patient  14  can have the treatment plan evaluated by a consulting service to recommend a course of treatment. The remote service offered through the plan comparison module  150  can also be utilized during or after treatment for the patient  14  to receive feedback as to whether treatment adjustments are desired, and to evaluate if monitored changes in tumor, RAR, or side-effects are consistent with any doses prescribed or received.  
       FIG. 6  illustrates a flow chart of a method of configuring a radiation therapy treatment device  18  from a remote location according to one embodiment of the invention. Local personnel perform (at  170 ) a set of predefined preparatory steps of the device  18 , such as setting up equipment. Local personnel request (at  174 ) via the quality assurance module  98  that the device  18  be tested or analyzed for proper operation. Remote personnel receive (at  178 ) the request and access (at  182 ) the quality assurance module  98  via the remote computer  78  and the network  82 . Remote personnel instruct (at  186 ) the test module  102  to conduct a particular test on the device  18  (e.g., conduct a test on operation of the gantry or the couch). After completion of the test, the remote personnel instruct (at  190 ) the analysis module  106  to evaluate the test results. The analysis module  106  generates (at  194 ) a report of the test results and transmits the report to the remote computer  78 . The remote personnel recommend (at  198 ) remedial action if necessary. The analysis module  106  can automatically recommend changes to the device  18 .  
       FIG. 7  illustrates a flow chart of a method of monitoring operation of a radiation therapy treatment device  18  from a remote location according to one embodiment of the invention. Local personnel request (at  202 ) via the service module  114  that the device  18  be monitored during operation or that environmental factors be evaluated or that external components be monitored. Remote personnel receive (at  206 ) the request and access (at  210 ) the service module  114  via the remote computer  78  and the network  82 . Remote personnel instruct (at  214 ) the monitoring module  118  to monitor a parameter of the device  18 , such as water flow, internal temperature, internal pressure, and the like or to monitor environmental factors, such as temperature, humidity, and air pressure or to monitor external components. The monitoring module  114  transmits (at  218 ) the acquired data to the tracking module  122 . The tracking module  122  compares (at  222 ) the data to historical data or predefined ranges to determine (at  226 ) if device component problems or environmental problems or external component problems exist. The tracking module  122  generates (at  230 ) a report of the results and transmits the report to the remote computer  78 . The remote computer  78  can access the tracking module  122  to retrieve the results. Based on the results, the remote personnel instruct (at  234 ) the service module  114  to correct the problem. The service module  114  can automatically correct the problem rather than wait for the report.  
       FIG. 8  illustrates a flow chart of a method of remotely reviewing a radiation therapy treatment plan for a patient according to one embodiment of the invention. Local personnel acquire (at  238 ) an image of the patient  14  and begin to generate (at  242 ) a treatment plan for the patient. The local personnel instruct (at  246 ) the treatment module  126  to notify remote personnel that a treatment plan has been generated. The remote personnel access (at  250 ) a computer  78  at a location different from the local personnel, and review, approve, modify, and/or deny (at  254 ) the treatment plan. Remote personnel can also view, edit, and/or approve patient plan optimization; view, edit, and/or approve patient contours; view, edit, and/or approve patient registration, and registration histories for a patient  14 ; view, edit, and/or approve adaptive therapy. If the remote personnel approve the treatment plan, the local personnel commence (at  258 ) treatment.  
       FIG. 9  illustrates a flow chart of a method of selecting a location for radiation therapy treatment according to one embodiment of the invention. Local personnel acquire (at  262 ) a patient profile (e.g., information or data relating to the patient) and transmit (at  266 ) the profile to a plurality of treatment planning locations. Alternatively, local personnel acquire patient information and transmit the information to be assembled into a patient profile. Each location generates (at  270 ) a treatment plan for the patient  14  based on the patient profile. Each location transmits (at  274 ) the treatment plan to the plan comparison module  150 . The plan comparison module  150  compares (at  278 ) the plurality of plans to make (at  282 ) a recommendation to the patient  14  of where to receive treatment.  
       FIG. 10  illustrates a flow chart of a method of scheduling radiation therapy treatment for a patient  14  at a medical center according to one embodiment of the invention. A medical center data module  142  acquires (at  286 ) throughput data, such as speed and workload, from a plurality of medical centers having a radiation therapy system  10 . The medical center data module  142  analyzes (at  290 ) the throughput data and determines (at  294 ) which medical center can accommodate the patient  14  most efficiently. The medical center data module  142  can also determine a particular treatment unit to use. The medical center data module  142  can also take into consideration patient willingness to travel, preference for particular clinical personnel, and other patient related factors.  
      Thus, the invention provides, among other things, new and useful systems and methods of remotely accessing a radiation therapy system. Various features and advantages of the invention are set forth in the following claims.