ProSoma 3D & 4D Simulation

The independent powerhouse of virtual simulation

Overview

Developed with Radiation Therapy Professionals

ProSoma virtual simulation software remains as the number one v-sim software package in the UK & Ireland. It’s ultrafast, comprehensive, truly clinical tools, developed by oncologists, radiographers/radiation therapists, means it stands apart from v-sim modules developed as add-ons to treatment planning systems.

ProSoma is independent and acts as a link between each and every device/software involved in the complete chain of patient’s radiotherapy planning and treatment and works with all makes of CT/MR and PET scanners plus all makes of TPS, OIS, all treatment machine on-board EPID and CBCT images and has connectivity with PACS. ProSoma Provides a seamless workflow from patient’s pre-treatment scan to treatment.

Bringing the virtual patient to life

ProSoma’s clinical imaging across all its modules enables 3D & 4D navigation from surface anatomy through to radiographic anatomy to 3D CT /MR/PET, even showing corresponding anatomical points in a 4D moving radiographic and CT display. 3D image tracking through organs linked to anatomical DRRs or MR imaging brings diagnostic radiology imaging power. Supporting electron and photon set-ups using this powerful imaging means that simulation and planning are truly clinical and verifiable.

Revolutionary breast planning

MammoShape combines a clinically palpated breast volume with 3D imaging with rapid volume auto-contouring in just a few seconds. Designed by radiation therapists and oncologists this is unique, powerful and extremely time efficient.

Planning to MU & dose in seconds!

When the additional module ProSoma CORE is installed, a rapid dose (Monte Carlo) and MU calc are performed in seconds – this means that in a single session without having to transfer beam information to a second system, a fully approved treatment prescription can be made. This applies to all non-static beam set-ups e.g. palliative, POPs with MLC shielding, static breast plans etc.

Automated adaptive RT analysis using daily CBCT

A new ProSoma Core mode has been introduced to utilise daily cone beam CT data (CBCT) to capture anatomical changes during the course of treatment. When CBCT data is sent to ProSoma together with the planning CT and RT data ProSoma will perform deformable image registration of the two CTs and transfer the RT Structure Set and RT Plan onto the deformed planning CT. It will then calculate the new dose distribution on that CT. DVHs and various dose parameters will be calculated automatically taking into account the current patient anatomy.

The results of the calculations are automatically captured to a PDF report available for review in ProSoma or via the ProSoma Web Portal and can be forwarded automatically to staff needing to review the results.

Cost-effective licensing and flexible working

The software is in daily use across the UK and Ireland, with multiple and site-wide licensing, shared access across hospital sites, remote access including Citrix, and virtualised installations.

The extensive functionality ProSoma brings, means multiple systems can be disseminated across departments so that users can work flexibly performing any clinical task at any time from any location, even remote access and secure data transfer from hospital to hospital anywhere in the world.

Excellence for training

For training students and new staff, ProSoma can be set-up so that multiple trainees can work on the same cases simultaneously – a powerful training tool used regularly in university environments. It provides the students with a thorough understanding of the complete planning process from pre-treatment scan, contouring, Beam setup, dose calculation, dose evaluation and acceptance of the plan, and exporting to the R&V system ready for treatment.

Features

3D & 4D imaging and navigation
Breast – the power of ‘MammoShape’
Auto-contouring in 3D & 4D
Head & neck imaging
Palliative planning to MU calc in seconds!
Adaptive CBCT planning review
SBRT 3D -4D image fusion
Dose, IGRT & portal review
Rapid scripting

3D & 4D imaging and navigation

Imaging - bringing the virtual patient to life

When moving from 'real' simulation to 'virtual' simulation, the biggest problem faced is the confidence in knowing that the virtual patient set-up will be as accurate as the real thing. ProSoma has many tools to make sure the virtual patient set-up will be as accurate as the real thing. ProSoma has many tools to make virtual patient accurate and life-like.

Surface observer-eye-view images with a virtual light field help achieve this. The projected light field accurately re-creates the divergent beam, so that even areas of 'splash' beyond the patient are seen. For the first time, it is also possible to visualise the exit beam in relation to the patient surface. Many more tools such as surface rulers, image mixing etc. aid the setting up and verification on the treatment unit.

From simple palliation to complex radical

When you are short of time, have a patient in discomfort on the couch, the ease and speed with which a plan can be simulated and exported to the treatment machine is critical. ProSoma excels in its ability to quickly apply beams either direct on the CT images, direct on the DRR, or even directly onto the skin surface view where any surface markers such as on a painful vertebra, a node or scar, can be visualised with the light field. Now with the additional option of ProSoma Core, users can quickly run a Primary Dose calculation using a fast and highly accurate Monte Carlo Dose engine, hence, streamlining the process and getting the patient on treatment without any delays. Especially beneficial for emergency cord-compression patients or during on-call periods.

ProSoma Contouring

Every ProSoma workstation includes a set of powerful contouring tools that have been designed for the demands of today's busy clinical radiation oncology workloads. An extensive suite of automatic, semi-automatic and manual tools provides accurate and fast delineation of tumour targets and normal tissue structures that need to be actively avoided.

Work-flow Wizard

ProSoma has an embedded Work-flow Wizard. This feature provides a step-by-step guide to users on using specific functions within the software encouraging users to follow a natural workflow through the interface and providing real-time guidance for various tasks like contouring.

Contouring and Navigating in 3D

ProSoma offers fast contouring in 3D where the user can contour on sagittal, coronal as well as axial slices. With a minimum of one contour defined on each plane, a 3D volume is automatically produced in seconds. Couple this with the ability to click on any anatomical point in any plan, to see the corresponding points in other planes, as well as in DRR and surface views, and you will see why ProSoma's contouring tools are so powerful. Traditional slice by slice contouring is of course also available with an accurate interpolation option.

Atlas-Based and Model Based contouring is available to optimise the contouring process whilst giving users freedom to add their contours to the Atlas Library and create new models for different structures.

MammoShape

The large numbers of breast cases and the increasing need to define PTVs have lead to the innovative MammoShape function. This allows the users to set the limits of the breast volume as if the clinical field limits were being defined conventionally. ProSoma's clinical skin surface OEV is used to draw the shape of the breast volume, and the 3D breast PTV contours are produced in seconds. This coupled with subtraction tools produces a shaped 3D breast PTV in a few minutes.

Automatic segmentation

Automatic segmentation for other body sites including algorithms for specialised head and neck shells, spinal cord, lungs, body, generic body cavities, kidneys, liver and heart including model-based contouring algorithms combined with the fast menu activation, offer a powerful range of options for all clinical scenarios.

Fast editing tools

In addition to the powerful automatic tools, a systems manual editing tools are critical to the smooth and efficient workflow in planning departments. We believe ProSoma has the most usable and fast tools available today. A simple right mouse click and all functions fall at the users fingertips.

ProSoma Image Fusion

Co-registering CT-MR, CT-PET & CT-CT is now a common requirement for radiotherapy planning. Algorithms need to be first of all accurate, then easy to use and flexible. The implementation in ProSoma is unique in the degree of flexibility the user has in how the fused images can be used after registration.

Once fused, images can be used immediately in any part of the software not only for contouring but also for full simulation, 3D navigation, dose review and also for IGRT and adaptive radiotherapy.

ProSoma IGRT, Dose and Portal Review

ProSoma is not just about simulation. It's powerful image handling and data communication with other systems lend itself to flexible ways of working, particularly when other systems are oversubscribed and often expensive to expand.

Dose Review

When expensive treatment planning workstations are tied up, ProSoma is the ideal alternative to review, but not change, the treatment plan. With the ability to import DICOM RT Dose files from TPS, ProSoma displays isodose curves/clouds and has an interactive spreadsheet so dose percentages and absolute values can be selected for display. Dose can be seen on fused images, so for example dose can be viewed over MR slices that have been fused with CT. Dose Volume Histograms complete this valuable clinical review function.

The James Cook University Hospital

We have been using ProSoma for contouring, image registration and unplanned workflows for a number of years. The recent addition of the “Core” module has benefited our treatment planning workflows by automating secondary dose calculation and providing full 3D dose calculations where we’ve previously relied on a single point dose calculation. The Monte Carlo algorithm works quickly (<2 minutes for a full patient dose calculation at 3mm voxel size and 1% uncertainty) giving excellent agreement with the Monaco treatment planning system (>98% gamma values at 3%, 2mm). Beam modelling can be difficult but the team at MedCom responded when we had questions or needed adjustments. We’ve saved a significant amount of time and energy per plan check and have quickly become used to a slick and efficient process.

Jim Daniel, Head of Treatment Planning & Brachytherapy

Southend University Hospital

Here, at Southend University Hospital, we use Prosoma as a starting point in the Radiotherapy Treatment Planning pathway. Once the patients have had their CT scan, the images are exported to Prosoma. All our contouring is done using Prosoma. We utilise features in Prosoma such as the auto contouring and model functions. These are particularly useful when outlining the organs at risk, allowing us to speed up the contouring process.

Furthermore, to aid the Oncologists during delineation, we often use the image fusion tab within Prosoma: where another imaging modality is imported and fused with the planning CT scan. Within the image fusion tab, we regularly use the auto fusion function to help when aligning the two scans.

Another feature of Prosoma that Southend Hospital benefits from is the use of scripts. This function is helpful and time saving for the treatment planner in creating margins for the Planning organ at Risk Volumes (PRV), especially when there are multiple volumes to create.

We also have recently started using Prosoma to analyse the dose distribution during Oncologist plan approval. The Oncologists find the dose evaluation module in Prosoma very helpful as they are able to access Prosoma remotely through Citrix and view the plan when they are off-site.

Overall, during the Treatment Planning pathway, we find Prosoma speeds up our workflow, from the auto contouring features to the use of scripts. Also, Prosoma has provided us with the platform for remote access Oncologist plan approval of the treatment plan. All of our Prosoma users find the software easy to use and navigate around.

R Cunningham, Pre Reg Clinical Scientist