Author: Yasin Abdulkadir, Justin Hink, James M. Lamb, Eric Nguyen, Justin Kyle Pijanowski, Yevgeniy Vinogradskiy 👨🔬
Affiliation: Department of Radiation Oncology, University of California, Los Angeles, Thomas Jefferson University 🌍
Purpose: To enhance a Radiation Oncology department’s cyberattack resiliency using a novel software that backs-up critical radiotherapy treatment information. The software returns essential information for on-treatment patients in an intuitive and accessible dashboard allowing clinics to continue radiotherapy treatments.
Methods: The Radiotherapy Backup and Recovery Dashboard Tool (RBRDT) performs daily backups of treatment information and relationships between DICOM-RT objects from the Record and Verify (R&V) system to the RTPACS. The RBRDT sends a C-FIND request to the R&V system to query for RTRECORD objects. If these RTRECORDs are not in the RTPACS, a C-MOVE request is sent to the R&V system to transfer the RTRECORDs to the RTPACS. The system notifies the team to resolve failed backups. For each RTRECORD, the RBRDT ensures the RTPLAN, RTSTRUCT, and CT associated with that RTRECORD are backed-up to the RTPACS. If the R&V system is inaccessible, the RBRDT accesses the backed-up data in the RTPACS to create a dashboard containing critical treatment information for patients currently undergoing radiotherapy.
Results: The RBRDT is implemented in our clinic and generates backups to the RTPACS every 10 minutes. Since its implementation in May 2024, the RBRDT backed up over 55,000 RTRECORDS, 100 RTPLANs, and 40 RTSTRUCTs to the RTPACS. Dashboard generation is routinely tested.
Conclusion: While Radiation Oncology departments impacted by cyberattacks performed data back-ups, they were unable to access these backups or their R&V system, and therefore failed to quickly resume patient treatments. The RBRDT is an improvement over existing approaches for data backup. All relational data is transferred to the RTPACS which is accessible during a cyberattack, eliminating 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.