Oncology information and record-and-verify systems (ARIA, MOSAIQ)
The software that holds a radiotherapy patient's plan, checks that the machine settings match it before every beam is switched on, and keeps the record of every dose given. Almost every department runs one of two systems.
Overview
Record-and-verify systems appeared in the 1980s after a series of treatment errors: the system receives the approved plan from the treatment planning software, compares each machine parameter (gantry and collimator angles, leaf positions, monitor units, energy, couch position) with the plan before the beam is enabled, and logs what was delivered. Modern oncology information systems have grown around that core into the department's electronic record: scheduling, imaging review and approval, adaptive workflows, chemotherapy prescribing, charge capture and clinical trial flags. Varian's ARIA and Elekta's MOSAIQ dominate; MOSAIQ is vendor-neutral and runs many mixed-vendor departments, ARIA is tightly integrated with Varian machines and the Eclipse planning system, and both connect to hospital electronic records through HL7 and DICOM-RT.
The systems are the department's single point of failure. Elekta's cloud outage in 2021 stopped treatment at dozens of North American centres for days, ransomware attacks have done the same, and interoperability between planning systems, machines and records from different vendors remains imperfect despite the IHE-RO profiles. A record-and-verify check also cannot catch an error already in the plan, which is why independent dose checks and patient-specific QA exist.
- Linac head + MLC
- Target (PTV)
- Gantry arc
- Cone-beam CT guidance
How it works
A database of approved plans is compared parameter by parameter with the treatment machine state before each beam is enabled, and the delivered parameters are recorded, with the same system serving as the department's scheduling and clinical record.
- Blocks delivery when machine settings do not match the plan
- Complete record of delivered dose
- Integrates scheduling, imaging review and prescribing
- Single point of failure for the department
- Interoperability across vendors remains imperfect
- Cannot catch an error that is already in the plan
Latest papers
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