What is the DICOM Detective?

To score a plan for a ProKnow Plan Study, you will first upload the DICOM RT Plan and RT Dose that you created with your treatment planning system (TPS), then generate your scorecard. When you prompt the system to generate your scorecard, processing beings. This processing includes the recalculation of dose volume histogram (DVH) statistics for each anatomic structure, the extraction of your metric results, the analysis of metric results vs. the scored objectives, the computation of the per-metric and composite scores, and finally the generation of a full report that includes the scorecard as well as per-metric drill down slides.

The data processing also includes a thorough analysis of the associations of the relevant datasets, namely the planning image set, structure set, plan and dose. This analysis is performed by the "DICOM Detective," and any resulting alerts will be displayed in the "Comments" section after you've generated your scorecard.

If you see one or more DICOM Detective notifications, it does not mean you did anything wrong! In fact, some notifications are common for these plan studies which by default always use fully de-identified (i.e., anonymized) datasets.

The purpose of these notifications is to help you (or ProKnow) diagnose any data upload errors. For example, you can quickly determine if you accidentally uploaded data for a different dataset/patient, or if you loaded the wrong plan with the dose or vice versa.

Potential DICOM Detective Alerts

Mismatches in Patient ID or Name

A basic dataset for a plan study will consist of these four entities: (1) a planning image set (usually CT, though MR simulation is also allowed), (2) an anatomy structure set, (3) the radiotherapy plan, and (4) the calculated 3D radiotherapy dose grid. The first two entities are standard and are provided on the "Download" tab. The plan and dose are always provided by the user.

If the Patient ID or Patient Name do not match exactly across all four entities, you will receive a notification.

This notification may indicate you selected a plan and dose for the wrong patient, or it may be benign and simply mean that you reassigned a new ID and/or name when you transferred the image set and structure set into your TPS.

Mismatches in RT Plan and RT Structure Set

DICOM Plan files have data tags that specify the instance of the RT Structure Set that was used in that plan's creation.

If your uploaded RT Plan does not reference the original, supplied structure set, you will receive a notification.

This notification is fairly common, and most often means the user made some structure edits (e.g., addition of new volumes that aid in optimization), so do not be alarmed if you get this notification. However, it may also indicate that you accidentally chose a plan for the wrong patient, which would also be indicated by the mismatches in Patient ID or Name.

Mismatches in RT Dose and RT Plan

DICOM RT Dose files have data tags that specify the instance of the RT Plan that produced that dose.

If your uploaded RT Dose does not reference the uploaded RT Plan, or if it does not reference an RT Plan at all, you will receive a notification.

This notification is less common, and should only occur if a "dummy plan" is used for a TPS that does not export a valid RT Plan, or if a composite/summed RT Dose is uploaded that does not reference any single RT Plan (e.g., for a sequential boost simulation in a TPS that does not create composite plans and doses). This notification may also indicate that you accidentally chose a dose for the wrong patient, or a plan-dose pairing that is not correct.