Passive tracking of linac clinical flow using radiofrequency identification technology

Abstract Purpose To analyze the implementation of a passive radiofrequency identification (RFID) clinical system and to evaluate the clinical workflow on 2 linear accelerators using the RFID technology. Methods and Materials The clinical area of a typical radiation therapy center was equipped with RFID readers and antennae, which included linear accelerator (linac) treatment vaults. Both were dual energy linacs (6 and 15 MV). One linac was an iX with RapidArc (Varian Medical Systems, Inc, Palo Alto, CA) and the other was a TrueBeam (Varian Medical Systems, Inc, Palo Alto, CA). Patients were given an RFID transponder card on their first day of treatment. Location timestamps were collected when the patients entered and exited the linac vaults. Each fraction was categorized by treatment machine, treatment site (brain, head and neck, prostate, and other), and treatment type (static field intensity modulated radiation therapy [IMRT], RapidArc, and 3-dimensional [3D]). The Mann-Whitney nonparametric test was used to determine statistical significance between median times in the linac vault. Results A total of 4302 fractions from 144 patients were analyzed over a 10-month period. With minimal staff training, an approximately 70% read reliability was achieved. The median treatment time for all treatment fractions on the TrueBeam linac was 11.0 minutes (n = 1425) while the median time was 11.9 minutes (n = 1576) on the iX linac ( P P P Conclusions Automatic remote reading of passive transponder cards is not without its challenges. However, with little or no clinical introduction, we experienced a read reliability that warrants further development. Our initial use of the system indicates that continual collection and analysis of workflow data may allow clinics to improve efficiency and safety.