Kitware customer highlight: MuriPlan from Xstrahl – A 3D Slicer based radiotherapy treatment planning system

Introduction

Kitware provides collaborative research, development, and technology-integration services for companies that work in the medical and biomedical business sectors. As part of a series highlighting many of the applications that Kitware has developed in collaboration with our customers, this post features our joint efforts with Xstrahl.

Xstrahl: The company

Xstrahl is the leading designer and manufacturer of superficial and orthovoltage medical X-Ray Systems for treating cancer and dermatological disorders as well as pioneering X-Ray research solutions for radiation biology research. They deliver an unsurpassed level of service from initial specification and suite design through to installation, on-going training, education and maintenance. With manufacturing facilities both in the UK and USA, the company operates globally through an international network of distributors.

More recently in the US, Xstrahl has worked with internationally renowned researchers and applied its extensive medical X-Ray knowledge to develop the powerful and customizable Small Animal Radiation Research Platform known as SARRP. It is designed to enable the preclinical research community with tools required to engage in the most clinically relevant, reproducible, and technically advanced studies. With over 55 systems worldwide, SARRP is the industry leader for matching the standard of care for clinical radiation treatments in a preclinical setting.

To truly replicate clinical practice, Xstrahl realized the need for a Treatment Planning System (TPS). In clinical radiation therapy, the TPS is used to plan geometric, radiological and dosimetric aspects of the therapy, involving advanced and intuitive tools to allow the planner to view three dimensional beam shapes and dose distributions superimposed on the patient anatomy. It represents a major part of the overall treatment process. Xstrahl launched their original TPS for the preclinical environment in April 2012, which was based on the powerful 3D Slicer platform. Then, with the help of Kitware, in 2014 Xstrahl launched MuriPlan: a completely revamped TPS with the focus of building an intuitive dose planning, verification, and delivery system that guides users through a step-by-step process of planning and executing their experiments.

MuriPlan was built on the same platform as the previous SARRP TPS. Since it’s initial launch, Xstrahl has worked closely with early-adopters and continually responded to customer feedback by adding advanced image-registration and contouring tools to better delineate tumor volumes, and advanced evaluation tools such as dose-volume histograms, volume metrics, and isodose lines. Another major driver in development was to facilitate high-throughput for multi-subject CT scans and fractionated treatments by adding tools to save and auto-transform treatment plans. A core focus of the software was to tightly integrate hardware and software, and thus MuriPlan is the single driver for imaging, robotic and X-Ray control on SARRP.

MuriPlan represents the very latest innovation in preclinical research and is now the most widely used preclinical treatment planning system in the world.

For more information on MuriPlan, see:

http://www.xstrahl.com/life-sciences/pre-clinical-systems/image-guided-irradiators/advanced-software.aspx.

 

Need: Why Xstrahl chose Kitware

Xstrahl, in collaboration with Johns Hopkins University, had internally developed a 3D Slicer-based treatment planning system that provides functionality related to user interaction, computation, and visualization. The software also interacted directly with their GPU-based radiotherapy dose computation algorithm.

They chose 3D Slicer because it is an open-source, extensible application for visualizing and analyzing medical images, with an established network of contributors. Funded by the National Institutes of Health (NIH), 3D Slicer is a maintained, reliable and modular platform. With more than 60 extensions providing functionality specific to domains like surgical navigation, radiation therapy, 3D printing, nuclear medicine and shape analysis, the 3D Slicer platform offers a broad set of building block to efficiently create specialized applications.

Based on additional requests from its users, Xstrahl needed professional engineering support to work with their internal team of developers to improve the software and extend its features. Kitware was a strategic choice, as we are one of the leading developers of 3D Slicer, and we have extensive domain expertise in image analysis and visualization.

In addition to plug-in improvements and extensions, Xstrahl was interested in adopting a high-quality software process to prepare its application for deployment. Specifically, Xstrahl wanted to incorporate a streamlined build process, resource-management tools, and best practices in software packaging.

The SARRP alongside its workstation running MuriPlan.

Solution: How Kitware helped Xstrahl fulfill its customer requirements

Xstrahl engaged with Kitware to help develop an Xstrahl-branded Slicer application that provides capabilities related to radiation therapy treatment planning specific to pre-clinical studies. Xstrahl worked closely with their customers to define the vision for their product. The branded application provides the same functionality that the Xstrahl engineers developed in addition to new functionalities that include: improved user interface interactions, a segmentation interface, isodose display, and more. The Kitware team adopted existing revision control systems and rolled out a high-quality software development workflow for Xstrahl.

The Kitware-and-Xstrahl team worked effectively by holding regular meetings to review progress, update project concepts, and refine priorities. This close collaboration has been very productive. The project is currently in its 6th phase.

An example of adding and repositioning treatment beams in 2D or 3D views

This screen shows the treatment verification step, displaying isodose lines and DVH with metrics

Summary

The project provides just one example of how Kitware partners with technology companies to build powerful applications using open-source solutions such as 3D Slicer. To learn more about how Kitware can tailor its solutions to meet your research needs, please contact kitware@kitware.com.

Questions or comments are always welcome!