Elekta ProKnow®

Interview with Emma Viviers, Treatment Planning Medical Physicist, University of Florida Health Proton Therapy Institute, Florida, USA

Can you tell us about who you are and what you do?

My name is Emma Viviers. I started off my medical physics career and qualified initially in the UK, and then completed my residency in South Africa. I am currently a treatment planning medical physicist working at the University of Florida Health Proton Therapy Institute (UFPTI) and I've been there for the last five years.

What specific indications do you treat with proton therapy at your institution?

At UFPTI, we've treated patients from all over the world since we started. When we first opened 15 years ago, we were one of the very few proton facilities. We do treat with photons, proton double scatter and proton pencil beam scanning therapy. The most prevalent indications for protons would be left breast, head and neck, cranio-spinal, chordomas, prostate, lung, and pediatric cancers.

The reason for using protons for all those indications is because proton therapy can often reduce dose to adjacent organs at risk, where it can affect cardiac, lung or neurological function and have the potential to either impact life or otherwise severely affect the quality of life. That is the determining factor.

How did you first hear about ProKnow, and what is your experience with it so far?

The first experience I had with ProKnow was through the contouring accuracy programs. I found that was a really good tool to be able to learn how to contour unfamiliar structures.

As a group, we started testing ProKnow in 2020, to see if it was going to be of benefit to us, either clinically or research wise. And then, in the last year, we've basically been extensively uploading our data into ProKnow and using it for analysis of a lot of our historical clinical data.

We have approached it from different angles already.

我们有一小部分具有特定反应的患者。我们回去查看数据并与所有其他患者进行比较，以查看他们是否以任何方式是异常值。我们还使用Proknow来建立我们的基准进行未来的质量分析，并且我们一直在使用数据和出口功能以及研究和出版物。

现在，我们的数据库中有超过2,000名患者，这些患者主要是儿科和乳房患者。在一个清洁的数据库中，我们可以在其中进行大数据分析的单一小儿患者确实增加了潜力，以便能够寻找趋势，以帮助未来的小儿治疗。没有很多具有很多长期历史的质子网站，因此，拥有一个使我们能够以易于分析格式来查看大量数据的解决方案至关重要。

Who uses ProKnow at your institution?

A very pleasant change for us going forward into using ProKnow is that the solution has enabled us to transfer the ownership of information towards the radiation oncologists. They now don't have to have a particular physicist available to be able to pull the information that they need. When it's one o'clock in the morning and they're lying awake, and they want an answer, they can quickly log into ProKnow and find their own answer from their own data. It started to be used predominantly by physics but going forward it's going to be used more by the radiation oncologists.

What was the first impression of the team when using the tool?

The first impression was largely on the accessibility of the software. Not everyone necessarily wanted to move away from an in-house software in which a lot of time and resources had been invested. Having a system like ProKnow that was so easy for everybody to access was a big help to being able to implement the change. We've had very positive feedback since then. It's very user friendly and extremely accessible. Any physician offered ProKnow jumps in and uses it immediately.

How do you see ProKnow being used in the future at your institution?

We are using ProKnow very much as a pristine clinical tool. But what we envisage in the future is that we will have a research workspace and a clinical workspace so that the one does not corrupt the other. This is a helpful feature of ProKnow, to be able to keep those workspaces separated.

在图表回合中，我们还一直在讨论研究计划质量，以确保我们不仅获得了一个可以通过我们的临床公差的计划，而且还希望从我们使用的方式中获得最佳计划。Proknow帮助我们确定了哪些患者从质子疗法中受益，而且哪些患者将从铅笔梁扫描与双分散中受益。这是我们将在新的一年中使用Proknow来提高我们的计划质量的每种方式。

What one feature of ProKnow could you not live without?

The accessibility. The fact that any of our clinical personnel with logins can access the clinical data that has been assigned to them from any device. We've even had collaborators from overseas, such as the NHS in the UK, with which we're able to share data with a click of a button. That gives everybody the ability to answer their own clinical research questions at the touch of a button and with a secured cloud solution. We don't need to be trying to transfer. To securely transfer this data—over a TB of information—in any other way would have been prohibitive.

有什么超出您期望的吗？

超出我们期望的是客户支持。我从来没有与一家愿意倾听您的关注的公司合作，并且每当您与他们联系以寻求客户支持时，作为改善其软件的一种手段。他们看到我们可以识别出的任何短缺，不仅是他们需要协助我们的东西，而且还可以改善所有用户的平台。

We have had some very fundamental changes that we needed to be able to implement the solution clinically—features like the relative dose function. From a programming point of view, I understand that was a fundamental change that the ProKnow engineers went away and made happen for us. It's really encouraging to see when we do have any sort of suggestions or ideas that they are very accommodating and implement a rapid improvement in the software with each release.

你真的have a fantastic team there, the way that they interact with us. From a software point of view as well as from a personal point of view, it has really been a pleasure working the team.

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