Document Type

Article

Publication Date

10-22-2025

Comments

This article is the author’s final published version in Journal of Applied Clinical Medical Physics, Volume 26, Issue 11, 2025, Article number e70292.

The published version is available at https://doi.org/10.1002/acm2.70292. Copyright © 2025 The Author(s).

Abstract

PURPOSE: Radiation Oncology departments impacted by recent cyberattacks were unable to access data backups or their Record and Verify (R&V) system and therefore faced challenges to resume patient treatments in a timely manner. We present a novel software tool that backs-up critical radiotherapy treatment information and displays essential information for on-treatment patients in an intuitive and accessible dashboard allowing clinics to continue radiotherapy treatments. The purpose of this report is to describe implementation details, challenges, and share open-source code to facilitate radiation oncology clinics' efforts to develop tools to improve cyberattack resiliency.

METHODS: The Radiotherapy Backup and Recovery Dashboard Tool (RBRDT) performs daily backups of treatment information and relationships between DICOM-RT objects from the R&V system and treatment planning system (TPS) to a Radiation Therapy Picture Archiving and Communication System (RT-PACS). If the R&V system is inaccessible, the RBRDT accesses the backed-up data in the RT-PACS to create a dashboard containing critical treatment information for patients currently undergoing radiotherapy.

RESULTS: The RBRDT is successfully clinically implemented and generates backups to the RT-PACS every 10 minutes. Since its implementation in May 2024, the RBRDT backed up over 80,000 RTRECORDS and moved 322 RTPLANS and 142 RTSTRUCTS to the RT-PACS that were absent from this server caused by human error. The dashboard is generated nightly.

CONCLUSIONS: The RBRDT fills a critical gap in existing approaches for radiotherapy treatment data backup and restoration. All relational data is transferred to the RT-PACS which is accessible during a cyberattack, reducing the reliance on the R&V system. The RBRDT retrieves connected data elements saved in separate locations. In the event of a cyberattack, this data is returned in a dashboard to rapidly resume patient treatments.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

PubMed ID

41126374

Language

English

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