Eclipse 16.0 Treatment Planning Customer Release Note

Eclipse Treatment Planning
Customer Release Note
16.0
P1038089-002-B DECEMBER 2019

Legal Information
Publication ID
P1038089-002-B
Publication Title
Eclipse Treatment Planning Customer Release Note
Abstract
This publication provides immediate release information for using Eclipse Treatment Planning version 16.0.
This publication is the English-language original.
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®
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Varian Medical Systems, Oncology Systems products are designed and manufactured in accordance with the
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2 Eclipse Treatment Planning Customer Release Note

WHO
ICD-O codes and terms used by permission of WHO, from:
● International Classification of Diseases for Oncology, Third Edition.
ICD-10 codes and terms used by permission of WHO, from:
● International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10).
EU REACH SVHC Disclosure

The link to the current EU REACH SVHC disclosure statement can be found at
http://www.varian.com/us/corporate/legal/reach.html
International Organization for Standardization ISO 13485

Varian Medical Systems, Oncology Systems products are designed and manufactured in accordance with the
requirements specified within the ISO 13485 quality standard.
13485
Medical Device
IEC 62083
™
Eclipse Treatment Planning System is IEC 62083 compliant.
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Legal Information 3
Table of Contents
Legal Information ........................................................................................................................................ 2
Introduction ................................................................................................................... 6
About Eclipse Treatment Planning .................................................................................................... 6
System Components and Compatibility ..................................................................... 8

System Components ......................................................................................................................... 8
Compatible Software Applications ..................................................................................................... 8
System Requirements ................................................................................................ 10

Recommended System Requirements ............................................................................................ 10
New Features and Enhancements ............................................................................. 11

New Features and Enhancements in Eclipse Treatment Planning 16.0 .......................................... 11
RT Peer Review ...................................................................................................................... 11
New Features in Contouring, Registration and SmartSegmentation ...................................... 11
New Features in External Beam Planning .............................................................................. 12
New Features in Halcyon Treatment Planning ....................................................................... 12
New Features in Clinical Goals and Clinical Protocols ........................................................... 12
New Features in Photon Optimization .................................................................................... 13
New Features in RapidPlan .................................................................................................... 13
New Features in Trade-off Exploration ................................................................................... 14
New Features in Proton Planning ........................................................................................... 14
New Features in Eclipse Scripting API ................................................................................... 14
New Features in Concurrent Editing ...................................................................................... 15
Changes from the Previous Release ........................................................................ 16

Changes in Eclipse Treatment Planning 16.0 ................................................................................. 16
Changes in Contouring, Registration and SmartSegmentation ............................................. 16
Changes in External Beam Planning ...................................................................................... 17
Changes in Halcyon Treatment Planning ............................................................................... 20
Changes in IRREG Planning .................................................................................................. 20
Changes in Cone Planning ..................................................................................................... 20
Changes in Photon Optimization ............................................................................................ 21
Changes in RapidPlan ............................................................................................................ 21
Changes in Trade-Off Exploration .......................................................................................... 21
Changes in Proton Planing ..................................................................................................... 22
Changes in Printing ................................................................................................................ 22

Changes in Beam Configuration ............................................................................................ 22
Changes in Import / Export ..................................................................................................... 23
Known Issues for Eclipse Treatment Planning ........................................................ 25

Known Issues for Eclipse Treatment Planning 16.0 ........................................................................ 25
Known Issues in RT Peer Review .......................................................................................... 25
Known Issues in Contouring, Registration and Smart Segmentation ..................................... 25
Known Issues in External Beam Planning .............................................................................. 27
Known Issues in Halcyon Treatment Planning ....................................................................... 28
Known Issues in Cone Planning ............................................................................................. 29
Known Issues in RapidPlan .................................................................................................... 29
Known Issues in Trade-Off Exploration .................................................................................. 29
Known Issues in Proton Planning ........................................................................................... 30
Known Issues in Printing ........................................................................................................ 30
Known Issues in Beam Configuration .................................................................................... 31
Known Issues in Conformal Optimization, Biological Optimization, and Biological
Evaluation ............................................................................................................................... 31
Known Issues in Eclipse Scripting API ................................................................................... 31
Miscellaneous Known Issues ................................................................................................. 32
Performance Information ........................................................................................... 33

Performance Information for Eclipse ............................................................................................... 33
Using Within a Citrix Environment .......................................................................................... 33
User Documentation and Support ............................................................................ 34

Related Publications ........................................................................................................................ 34
Contact Customer Support .............................................................................................................. 34
Table of Contents 5
Introduction
About Eclipse Treatment Planning

The Eclipse Treatment Planning System is used to plan radiotherapy treatments for patients with
malignant or benign diseases. Eclipse TPS is used by medical professionals trained in radiation
dosimetry for patients considered suitable for radiotherapy by an oncologist. Eclipse is used to
plan external beam irradiation with photon, electron, and proton beams, as well as for internal
irradiation (Brachytherapy) treatments. Eclipse is part of Varian’s integrated oncology
environment.
WARNING: This customer release note is intended for radiation therapists, radiation
oncologists, dosimetrists, and medical physicists who are qualified and
properly trained users of the above mentioned hardware and/or software.
The users must be familiar with all functions, the consequences of all
operations, and the potential hazards involved.
WARNING: In Eclipse and/or BrachyVision integrated with ARIA Radiation Therapy

Management, any changes made in RT Administration will affect all of the
integrated applications and not just the workstation or application from
which RT Administration was accessed.
For example, the Planning Coordinate System specified in RT
Administration defines a static coordinate axis system that applies to all
clients that connect to the common Varian System Database. These and
other configuration parameters are shared by Eclipse, BrachyVision, and
ARIA RTM applications. Consult the user documentation for individual
software applications for more information.
WARNING: It is recommended to verify and confirm the patient setup with an

appropriate position verification method before treatment, especially when
the couch shifts printed in the plan report are used.
Sample plans may be generated using, for example, anthropomorphic
phantoms and actual patient setup positions compared directly with couch
shift values printed from Eclipse.
CAUTION: Concurrent editing can result in loss of data if users are not paying enough
attention to the messages that appear in the application. There are
different behaviors in the way the users are informed depending on the
application type.
Pay close attention to any warning messages that appear. Loss of data
can be avoided if users are informed about concurrent editing and take
appropriate actions.

CAUTION: In the virtual simulation process, Eclipse must know whether the laser
system is aligned to the DICOM Origin or to the CT center pixel. Alignment
to the CT center pixel means that the CT scanner isocenter is located at
the center of the CT image and aligned with the laser system. The CT
scanner protocol may shift the CT image in a way that it is no longer
centered to the CT center pixel. This can lead to Eclipse incorrectly
calculating the coordinates of the isocenter to be marked on the patient’s
skin using the laser system. When using the incorrectly calculated
coordinates, the laser system will point to wrong isocenter positions, and if
not verified carefully, the patient can be treated in the wrong position.
CAUTION: All beam data and calculation model files within Eclipse contain checksums
and are managed by Beam Configuration. Do not edit these files manually.
If differences are found the system will issue a warning “Warning : <name
of the parameter file>. Check failed.” If this occurs, verify and revalidate
(reapprove) the beam data or calculation model for which this warning has
been issued.
Note: Any abnormal termination of the application may cause loss of critical patient data. The
methods listed below are some common ways of ending a software program that is
unresponsive or that appears to be “frozen”.
● Pressing the CTRL+ALT+DEL key combination to open the Windows Security dialog
box and then (a) selecting Shut Down to end the computer session or (b) selecting Task
Manager to end the program. In either case, data loss may occur as a result.
● Accessing Task Manager directly by right-clicking the Windows Task Bar and then
selecting End Task to end the “frozen” program. Data loss may occur as a result.
● Powering down the computer using the hardware power switch.
● Pressing and holding the Reset button.
Any method used to terminate the software program may cause loss of treatment plan data.
Note: Regional Settings in the Windows operating system using commas as the decimal
separator are not recognized by Eclipse. For example, the entry “1,23” will not be recognized as
“1.23” ”. The decimal point “.” shall always be used regardless of the Regional settings.
Note: Transport Layer Security (TLS) protocol 1.0, 1.1 and 1.2 are supported by ARIA and
Eclipse TPS. When you are planning to update the TLS version, first contact your local Varian
service representative.
Introduction 7
System Components and Compatibility
System Components
This CRN applies to the software release that contains the following system components:
● Varian System Server, Release 15.1
● ARIA Radiation Therapy Management Client, Release 16.0
● Biological Optimization, Release 1.6.1.4
● Biological Evaluation, Release 1.6.1.4
● Conformal Optimization, Release 1.6.1.4
● DICOM Services, Release 16.0
● ARIA DICOM Import and Export 16.0
● Eclipse Distributed Calculation Framework, Release 16.0
● Eclipse Cone Planning, Release 16.0
● Microsoft SQL 2014 Standard and Enterprise
● Microsoft Internet Explorer, version 11
● Contouring, Image Registration and SmartAdapt, Release 16.0
● Plan Model Library 1.0
● Plan Converter, Release 1.0.0.9
Compatible Software Applications

The following software applications are approved for use with Eclipse:
● ARIA Oncology Information System for Radiation Oncology 15.6.1
● Image Browser 16.0
● Offline Review 16.0
● Portal Dosimetry 16.0
● RT Summary 16.0
● Tx Preparation 16.0
● Smart Segmentation Knowledge Based Contouring 16.0
● Varian RPM Data Converter 2.5
The validation for the following applications is limited to installing them and verifying that they do
not adversely affect Eclipse.
● Adobe Acrobat Reader 11 or DC
● Microsoft Office 2013 and 2016
● Cute PDF version 3.2
● .decimal p.d. 5.1.11
● IMSure 3.8.0
● K&S DIAMOND dose calculation 6.2.7
● MUCheck version 10.0.0

● RadCalc version 6.4.2.0
● Google Chrome, version 78
Note: Consult with the software vendor to determine the compatibility of any 3rd party
applications with 64-bit operating systems.
System Components and Compatibility 9

System Requirements
Recommended System Requirements

Refer to https://www.varian.com/oncology/products/software/treatment-planning/eclipse-
treatment-planning-system and select “resources” for current and specific details regarding
minimum hardware and operating system specifications.
Version 13.7 was the last Eclipse DCF version that supports the PBC algorithm, version 15.0 and
newer do not support PBC algorithms.
Version 15.1.1 was the last Eclipse DCF version that supports the GGPB algorithm, version 15.5
and newer do not support GGPB algorithms
Version 15.6 was the last Eclipse DCF version that supports the DVO and PRO algorithms,
version 16.0 and newer do not support DVO and PRO algorithms.
There is no 16.0 version of the PGO algorithm available. Eclipse version 16.0 supports PGO from
version 15.1.1 MR1 back to version 10.0.
Digitizers, Vidar scanners and Frame Grabber Cards (Matrox) are no longer supported.
Version 15.6 was the last version where SRS Localization 15.1 could be installed and used.
Version 13.5 was the last version compatible with Eclipse Ocular Proton Planning (EOPP).

New Features and Enhancements
New Features and Enhancements in Eclipse Treatment Planning

16.0
RT Peer Review
RT Peer Review is a new application that allows you to perform review sessions for plans
identified with bookmarks in External Beam Planning. You can also include a plan in a review
while performing planning approval in External Beam Planning.
A review session gives you quick access to various patient information stored in the ARIA OIS
and Eclipse database:
● Patient demographics
● Treatment prescription
● Diagnostic information
● Imaging, contouring and treatment plan information
● Last treatment or imaging date
During a review session, bookmarks and plans previously prepared in External Beam Planning
are displayed in read-only mode. During the review, you can capture notes and action items that
will be available to attendees to follow up.
You can add bookmarks for plans, plan sums and 3D images in External Beam Planning. You
can open the bookmarks directly in External Beam Planning or via RT Peer Review.
New Features in Contouring, Registration and SmartSegmentation

● Structure modeling and structure creation have been modified as follows:
● A structure ID can now be up to 64 characters long.
● Structure creation is now started by selecting a Structure Code.
● The Structure Properties dialog box has been modified. For example, the Structure
Code selection and the Comment text box are now on the General tab.
● Plan creation now starts by selecting plan target structure instead of plan target
volume.
● In the Focus Window, structures of volume type PTV, CTV, and GTV are now shown
first, above other structures of the structure set.
● When creating a new reference point, you can now define its type as Target or Organ
at Risk.
● Drawing tools can now be displayed in the toolbar with various optional ways to display
them.
● Structure label is now called structure code.
New Features and Enhancements 11

New Features in External Beam Planning
● A new tool, Import Dose Distribution as Plan, can now be used to import an RT Dose
when an image or structure set with a matching geometry (Frame Of Reference) is active
in the application.
● There is a new bolus creation tool, Bolus on Body. With a bolus created with Bolus on
Body, the effective thickness for overlapping bolus layers is now calculated by adding up
the layers, when previously the thickness was defined by the thickest layer alone. The
VOI tool for creating a bolus is also still available in Eclipse. Additionally, the bolus
thickness is now marked next to the bolus structure and is available in the print report.
● There is a new layout option in External Beam Planning which shows two orthogonal
views and two Model Views simultaneously. In the Model View, it is now possible to
quickly change between the 3D Model View, Dose-Volume Histogram View, Beam’s Eye
View, and the Arc Plane View.
● You can invert the mouse wheel zoom direction in Tools > User Preferences.
● A new view option has been added that allows to turn on/off the colored band in the DVH
when hovering over the clinical goals.
● A new shortcut key Ctrl + F9 allows creation of a setup field.
New Features in Halcyon Treatment Planning

● It is now possible to calculate the dose for a Halcyon plan with Acuros XB dose
calculation algorithm, including MV imaging fields.
● In a Halcyon 3.0 treatment unit, the maximum distance between treatment isocenters is
10.5 cm and treatment planning can now be done accordingly. In Halcyon 2.0, the
maximum distance is 8 cm.
● In Halcyon 1.0 and 2.0, a plan can contain at most 10 VMAT fields. In Halcyon 3.0, the
maximum number of VMAT fields in a plan is 20.
New Features in Clinical Goals and Clinical Protocols

You can now define clinical goals for plans and plan sums without the need for a clinical protocol.
Clinical goals can be entered manually, or with the use of a clinical goal template. In addition, you
can copy a set of clinical goals to other plans or plan sums for the same course.
Clinical goals allow you to define an acceptable variation value for each clinical goal.
Clinical goals are added and modified by selecting Planning > Add or Edit Clinical Goals. The
templates can be created from an existing plan with clinical goals, and they are managed in
Planning > Templates and Clinical Protocols > Clinical Goal Template Manager.
With the new view layout Multiple Plan Comparison, available in Plan Evaluation, you can
evaluate the results of clinical goals for multiple plans at the same time. You can also see the
DVHs of the plans and the dose distributions on the transversal slices.
Within clinical protocols, plan objectives are now divided into two categories: clinical goals and
prescription objectives. The term plan objective is no longer used. The prescription objectives and
clinical goals defined in the clinical protocols are available in the print report along with the
results.

For upgrading customer:
● Clinical protocols created in earlier Eclipse and BrachyVision versions will need to be
reviewed and updated to allow the full benefit of the changes.
● All plan objectives defined earlier in first section of plan objectives will be kept. To benefit
of having results in the new Clinical Goals Summary, these goals will need to be
manually redefined under the Clinical Goals section. Clinical goals linked to the plan
prescription should be kept in the Prescription Objectives section.
● All plan objectives defined earlier under Quality Indices will be transferred automatically
under the Clinical Goals section. It is advised to review these clinical goals and define a
priority to each individual clinical goal.
● All plan objectives defined earlier with the equal operator will be flagged as invalid and
need to be modified.
● If you have created a plan under a clinical protocol before V16.0 and want to save it as a
'new clinical protocol' in V16.0, the clinical goals will not be saved automatically in that
clinical protocol. Perform following workaround: Copy and paste the plan to you keep the
original plan, and unlink the clinical protocol reference from the copied plan. The
prescription objectives will be lost but clinical goals will be kept in the copied plan. Create
a new clinical protocol from the copied plan, the clinical goals will now also be saved.
New Features in Photon Optimization

● A single calculation model type, Optimization, is now used for both IMRT and VMAT
optimization.
● In addition to IMRT optimization and Acuros XB dose calculation, it is now possible to use
graphics processing unit (GPU) calculation also for VMAT optimization. More information
on GPU calculation: Eclipse Photon and Electron Algorithms Reference Guide.
● The PO algorithm now supports optimizing a multi-energy plan, that is, a plan with any
combination of energy modes in IMRT or VMAT plan fields. If Acuros XB is used for
calculating dose for a multi-energy plan, field dose calculation must be used. If plan dose
calculation is set to on in calculation options, the setting is automatically changed to off,
and a message is shown.
● In the Optimization dialog box, the Fields expander shows all the field setup details and
optimization parameters you can define separately for each field. The Treatment Unit
expander has been removed.
● In the Optimization dialog box, the Focus on Structure tool has two new options: Focus
on Structure Maximum Dose and Focus on Structure Minimum Dose.
● Irregular Surface Compensator plan creation is now using PO calculation model instead
of DVO for all treatment units and all MLCs supported in Eclipse.
New Features in RapidPlan

● You can define multiple target dose levels in a DVH estimation model.
● When creating a new DVH estimation model, you need to select the particle type (photon
or proton).
● Multiple isocenters in a plan are supported for photon models (proton plans may have
different isocenters but the DVH Estimation algorithm does not treat them any differently
than single isocenter proton plans).

● When adding a new upper gEUD optimization objective to a DVH estimation model, you
can let the DVH estimation algorithm generate both the priority and dose limit (% or
cGy/Gy) for the objective automatically.
● DVH Estimates can be printed even when there is no dose calculated.
● DVH Estimates can be printed in a plan comparison DVH.
New Features in Trade-off Exploration

● The Clinical Goals tab shows clinical goals for plans that have clinical goals defined. You
can use the new tools on this tab to automatically explore how the current tradeoff
exploration range can fulfill the clinical goals.
● Local Dose Correction can be used to further improve the trade-off exploration results
in an explored plan. You can select a point in the dose distribution (for example, the
hottest or the coldest spot in a structure), and use the local dose correction tools to
explore the effect of increasing or decreasing dose locally around the selected location.
Before local dose correction is started, the dose for the explored plan is calculated with
the AAA or Acuros XB algorithm.
● You can select the type of reference DVH shown in the DVH View during trade-off
exploration and local dose correction. A number of new reference DVH options are
available.
● In trade-off exploration, you can undo and redo the slider movements with the new Undo
and Redo tools.
New Features in Proton Planning

● RapidPlan for Protons: DVH estimates and optimization objectives can be generated
from DVH estimation models. A DVH estimation model uses knowledge from existing
treatment plans to generate DVH estimates and estimate-based optimization objectives
in optimization. The data from the existing treatment plans is extracted and then used to
train the DVH estimation models. DVH estimation models are configured, trained and
managed in the DVH Estimation Model Configuration workspace. When you use a
DVH estimation model to generate DVH estimates and objectives in a plan, you can use
all the features in the Optimization dialog box in the same way as in optimization without
a DVH estimation model.
New Features in Eclipse Scripting API

● Many new properties, functions, and classes have been added or changed in ESAPI
16.0. See the detailed documentation in Eclipse Scripting API Online Help. The most
significant changes and additions are Halcyon support, improved plan sum support, base
dose planning, clinical goals, and proton support.
● Visual scripting now contains a new menu item: Export/Create ESAPI project. It is now
possible to convert Visual script into Visual Studio ESAPI project, which can be edited/
compiled and run as Eclipse binary plugin. Due to that:
● The Code tab has been removed.
● PlanSetup Clinical Goals added in ESAPI 16.0 are accessible also in Visual
Scripting.

● The DVH Metrics element now works with PlanSum.
New Features in Concurrent Editing

It is now possible for different users to work on different structure sets of an individual patient at
the same time. This allows the plan to be started while another member of the team is generating
the structures which can be later copied. This is particularly useful for brachytherapy where time
is of the essence. It is recommended that the 3D images and structure sets are clearly named so
that it is easy to identify the planning image. Several warnings will be shown to inform the user
that someone else is working on the patient and work can still be lost if these warnings are
ignored when contours are edited on the same structure set.

Changes from the Previous Release
Changes in Eclipse Treatment Planning 16.0
Changes in Contouring, Registration and SmartSegmentation

● Earlier, the name of the last modifier was changed for all structures when a couch
structure was added to a CT dataset after all structures were contoured. This issue has
been solved.
● The issue, where for semi-automatic contouring tools, the Undo function was grayed out,
has been resolved.
● The issue, where the Segmentation Wizard for lungs in combination with the VOI
sometimes did not contour the lung, has been resolved.
● While inserting support structure models, the Window/Level settings are automatically
set to better visualize low-density patient immobilization devices. Manual adjustments of
Window/Level settings is now enabled.
● The issue, where data could get corrupted for exported deformed PET images from
Image Registration, has been resolved.
● Changing the settings in Contouring while a second Contouring instance is open, will
update the settings also in that second instance.
● When creating a phantom image via the New Phantom Image dialog box, and the
planning coordinate system is set to something other than “Standard” in RT
Administration, the dimensions assigned to the X, Y and Z axes of the phantom are now
correct, and will match the entered values.
● The issue, where the body structure created by Smart Segmentation was a high
resolution structure when expert case contains a high resolution structure in Smart
Segmentation, has been resolved. The body structure will not turn into high resolution
structure automatically.
● In the case that an extremely large structure was converted into a high resolution
structure, it might be impossible to reload the patient because the number of pixels for
this structure exceeded an internal limit of 1e9 pixels. This issue has been resolved.
● VOI (Volume of Interest) is now correctly applied for the Image Thresholding tool,
segmentation will only be done inside VOI.
● The Previous and Next Plane is visible again during contouring with the Brush tool
when the setting Show brush tail is off.
● When adding a couch structure in Contouring, the image is now resized with a 20 mm
additional margin around the couch structure (as in External Beam Planning).
● The 4D volume statistics window in Contouring indicates now that the used coordinate
system is the Dicom coordinate system.
● When using the Brush or Eraser tool in 2D mode on a transversal image (no tilt), the
structure in the neighboring image slices is not affected anymore. In previous versions,
some small fluctuations could occur.
● In previous versions, the Apply button in various contouring tools (for example Post
Processing tool) was always working on the original contours when opening the tool,
which could cause unexpected results when applying two or more times with different

settings. As an example: when removing a selected part of a structure using the Post
Processing tool and pressing Apply, and then trying to remove a second part of
structure and pressing Apply, the second part was not removed but instead the first
removal was canceled.
● The issue, where single pixels of a high-resolution structure with rendering type Segment
were not rendered in Contouring, has been resolved.
● When using the Boolean tool in advanced mode and entering the name of the input
structure as the only expression using a VOI, the input structure is not anymore cropped
to the VOI if the target structure is different.
Changes in External Beam Planning

● When a dose relevant plan change was done (for example, the number of fractions is
changed), the motion protocol got unlinked from the plan without notification. Then the
motion protocol had to be reselected again from the Treatment Preparation application.
This issue has been resolved, the link with the motion protocol will be kept in case a plan
gets changed.
● The custom DVH metrics, available in the Dose Statistics tab of the Info Window, can
now be defined to be plan-specific. The user-specific custom DVH metrics are still
supported as global metrics that can transparently be used in individual plans. The star
symbol button in the UI is used to select the user-specific metrics.
● When a block ID or tray custom code is changed for a plan that has a calculated eMC
dose, the MU values will not be unnecessarily cleared anymore and the dose will be kept.
● Creating the 3D volume from the two image series in External Beam Planning and
Selection could produce a volume with a crosshair-shaped artifact. This issue has been
solved
● When one bolus structure is used by two or more calculated plans, and bolus structure is
being cleared by using the right-click menu option from bolus structure: Clear > from All
Planes of Primary Image, the following message will be shown: “The selected bolus is
linked to a field with calculated dose distribution. Modifying the bolus will zero the dose
distribution for that field. Do you want to continue?”. When you select Yes, the bolus
contours will be removed, and also the dose distribution and MUs will now be removed
correctly.
● The issue, where the two first check boxes for 2D and 3D display did not work in the
Relative/Absolute Dose Isolevel Editor, has been resolved.
● The option Reset MLC is now also available for fields with dynamic MLC.
● User is now asked if couch rotation should also be opposed when creating opposing
fields. This is only done if the couch rotation is non-zero and the resulting couch rotation
will be within operating limits.
● The Leaf Labels tool is now also available in External Beam Planning.
● A defined MLC aperture can now be used as input for the irregular surface compensator
creation, which will be taken into account during fluence creation.
● It is now possible to duplicate an isocenter group. The new isocenter group is added at
the viewing plane intersection.
● The option to separately calculate the dose for a single plane has been removed. The
option was introduced at the time when the volume dose calculation was significantly
Changes from the Previous Release 17

slower. The current volume dose calculation quickly calculates the dose also for a single
plane.
● Previously, the dose representation of isodose lines could be incorrect in a plan that was
calculated and imported from a 3rd party treatment planning system. The incorrect dose
representation was visible if the isodose levels were defined with a value higher than the
maximum dose. For example, if the maximum dose of the plan was 110%, the isodose
line of 120% was shown where the 10% dose was (120%−110%=10%). This issue has
been resolved.
● An additional check box is added on the second page of the plan approval wizard that
you need to select in case you want to approve a plan without dose or MU.
Changes in Clinical Protocols and Templates

● Editing of the treatment site list within the clinical protocol or templates in External Beam
Planning and Brachytherapy Planning is not possible anymore. In case you want to
modify the treatment site list, you need to do it in the Prescribe Treatment workspace.
● When exporting and importing a reviewed or approved structure template, plan template,
clinical goal template or clinical protocol, the status of the template or clinical protocol is
now set to unapproved.
● FFF energies can now be saved within a clinical protocol and FFF energies can also be
selected when creating a plan using a clinical protocol.
● The issue, where the energy had to be defined manually when creating a plan from
clinical protocol, has been resolved. The energy of the plan template that is part of the
clinical protocol is automatically populated again.
● A primary reference point can be defined again when applying a clinical protocol, in case
the patient has no reference point yet.
● The dose unit is now part of the isodose level templates and will be indicated with [%] in
case of relative dose and [(c )Gy] in case of absolute dose. Isodose level templates
created in earlier version, will be transferred as relative isodose templates. Go into RT
Administration > Templates > Isodose Level Templates and modify the unit if needed.
● Selection of the isodose level template can now also be done in the 2D view. Right-click
on Isodoses to select one of the stored isodose level templates.
● Earlier, when an isodose template where all 3D surfaces were hidden was applied, all 3D
surfaces were shown. This issue has been resolved.
Changes in DRRs and Structure Outlines

● Structure outlines on DRRs can now be defined for one DRR or all DRRs in External
Beam Planning by right-clicking on DRR > Create structure outlines. Structure outlines
can also be defined on DRRs where the plan is planning approved.
● If, after plan approval, the DRR images are modified (for example, the DRR is edited or
the gantry angle of a setup field is changed), the structure outlines on the DRR are
updated automatically. No plan revision is needed anymore for these changes.
● If a structure set linked to another image was assigned to a plan that already contained
fields with live DRRs as reference images initially created in Treatment Preparation
workspace, the DRRs in the plan were kept, but were not set anymore as reference
images. This issue has been resolved.

Changes in the Arc Geometry Tool
● The issue, where the Arc Geometry tool crashed if an empty couch structure was
present in the structure set, has been resolved.
● Earlier, the Arc Geometry tool generated wrong arc directions for the 2 isocenters – 8
arcs option, where fields 4 to 8 had the same gantry direction rotation. This issue has
been resolved.
● In the Arc Geometry tool, by default, the isocenter will be adjusted based on the target
volumes selected, also for one single isocenter. In case you want to keep the defined
isocenter position, select the Retain isocenter position check box before selecting
target volumes.
● The Arc Geometry tool could result into an initial plan geometry where some part of the
target was not covered, when a setup field was present before entering the tool. This
issue could happen for plans with single or multiple isocenters. This issue has now been
resolved.
● The Target Coverage option has been detached from the Arc Geometry tool and is now
a general Eclipse tool that can be accessed by Planning > Plan Target Coverage.
Changes in the Freehand Tool

● When using the smart mode of the Freehand tool in External Beam Planning (first
function of the Freehand Tool), the behavior of applying the changes was different when
contour was completely closed or if it was not closed but finished with right mouse click.
This has been changed and both are behaving similarly now. The correction mode of the
Freehand tool might introduce small modifications to the contour or segment part that
was not part of the modification. This behavior applies also to the Freehand tool used for
drawing block shapes.
● Control pane of the Freehand tool now has a close button. In addition, the tool
deactivates itself when the control pane is closed.
Changes in Field-in-Field Technique

Some small improvements have been made to the field-in-field workflow:
● You can now use jaw tracking with the field-in-field feature for TrueBeam machines.
● If the main field is defined to use jaws without MLC, the system will automatically add the
MLC around the defined jaw aperture of the main field when a subfield is added.
● When opening the Field Weight dialog box, the ‘interactive apply’ option is turned on by
default.
● When a second subfield is created, the weight of the first subfield will be locked
automatically.
● The DRR defined in the main field will be copied to all subfields.
Changes in Planning for Elekta

● The issue, where the calculation of a verification plan for a Elekta Synergy or Agility plan
that contains a motorized wedge stopped with following error message: “ERROR! Cannot
adjust the field weights to achieve preset MU values because the dose calculation did not
define MU factors for all treatment fields in the plan', has been resolved. Verification plan
for a treatment plan with motorized wedge will now be created successfully and dose
calculation will succeed.

● The issue, where the MLC shape tool only can create a maximum opening of 16 cm × 16
cm for an Elekta Beam Modulator, has been resolved.
● An approximation of the effective angle of a motorized wedged field can be seen in the
Accessories tab of the Field Properties dialog box.
Changes in Halcyon Treatment Planning

● The complement angle setting was not taken into account in the Arc Geometry tool for
the Halcyon treatment unit if the geometry was set to 1 isocenter and 3 half rotations.
This issue has been resolved.
● Setting the Beam’s Eye View (BEV) for kV-CBCT by right-clicking in the Model View is
working again.
● When the field selection was unselected and re-selected in the Focus Window, a MV
portal image was wrongly displayed in the Beam's Eye View (BEV). This has been
resolved, now only the reference image or live DRR linked to the selected field will be
displayed.
● Halcyon version 2.0 plans with the isocenters being 8.01 cm apart, will not pass plan
validation anymore.
● As of version 15.6 MR3, with a field with flattening sequence equal or larger than 19×19
cm, the supported collimator angle ranges are 270° − 300°, 330° − 0° − 30°, and 60°
− 90°.
● The fixed sequence field will not lose the fixed sequence field type anymore after the
Opposing Field tool is used.
● When creating a partial treatment plan, the existing imaging fields will be kept.
● The Fixed Field Borders option available in smartLMC is working now also for Halcyon.
● The fluence defined by the irregular surface compensator for Halcyon machines, is now
also calculated correctly when the couch structure falls between the beam and the body
entrance.
● VMAT optimization for Halcyon SX2 will now result in valid MLC sequences when a
conformal arc field is used as starting point and optimization is continued from that.
Changes in IRREG Planning

● IRREG planning supports only the STATIC technique. In case in Plan Parameters a 2D
plan with the SRS STATIC technique is created, conversion into an IRREG plan will not
work and an error will indicate that the field(s) is not STATIC.
● If an IRREG plan is added to a course that contains another plan, which does not contain
a frame of reference UID, the IRREG plan will set the frame of reference UID, but this will
no longer cause a problem with the other plan.
Changes in Cone Planning

● The issue, where Cone Planning crashes if you used the Edit Treatment Order
command to change the order of the isocenters, has been resolved.
● Using a rectangle to define zoom with the zoom tool can now also be used in Model
View next to the 2D views, like in External Beam Planning.

Changes in Photon Optimization
● The issue, where the part of the structure that is partially outside the body or outside a
bolus gets zero dose and might affect the optimization outcome, has been resolved.
● An MLC leaf pair for the Halcyon SX1 and SX2 MLC is no longer red or report an error
during dose calculation, in case the optimized closed leaves are closer than the
recommended 2 cm spacing between neighboring leaves in the proximal and distal MLC
layer.
● For plans with very challenging objectives (for instance, multiple avoidance structure
objectives), a very low MU or plan quality was observed when skipping resolution levels
or using the continue from previous MR3 level option in combination with the extended
convergence mode on. This issue has been resolved.
● The issue, where a small shift could be seen in the optimization dose matrix for images
with non-HFS patient position during optimization and MCO, has been resolved. This
could happen when the optimizer resolution differs from that of the image.
● LMC MSS is now also using the defined minimum static leaf gap for Elekta MLC80,
MLCi2, Siemens 58MLC and 82MLC for the parked closed leaves.
● The optimization calculation log in the Field Properties dialog box and in printout now
provides information of what base dose plan was used during optimization.
● Structures and optimization objectives list in the Optimization dialog box now allows
removing all optimization objectives at once. For each visible structure, all optimization
objectives of the structure can now be removed at once. Moving mouse over a group
removal button highlights the objectives that will be removed. Removing all objectives
requires confirmation, removal is disabled when optimization is running. Optimization
objectives can only be removed in interactive optimization.
● Structure focus tool has now two additional options: set the focus to the minimum or
maximum dose of the structure when selecting the structure in the list.
● Indeterminism in VMAT optimization results has been improved when using PO algorithm
with CPU. When running the VMAT optimization with CPU twice with the same settings,
very similar results will be given. This is also valid when using aperture shape controller.
Changes in RapidPlan
● The dose prescription exported from Model Configuration and displayed in Model
Analytics is now rounded to a 2-decimal precision.
● The issue, where RapidPlan algorithm could underestimate or overestimate the dose
when applying a multi-isocenter or single isocenter model to a multi-isocenter plan in
photon optimization, has been resolved.
● In previous versions, importing DVH Estimation models required the write access to the
model file. Now only the read access is required.
Changes in Trade-Off Exploration

● The issue, where optimization of the deliverable VMAT plan produced sub-optimal results
in a case that contained objectives for a very small single image structure, has been
resolved.
● There was an issue in 15.6 Trade-Off Exploration when using Hybrid-MCO for plans with
objectives that preferred low doses for organs at risks. In such a case, the IMRT

optimization used for the Hybrid-MCO mode could stop after a few iterations if it was not
able to further improve the dose for some structures. As a result, it was not possible to
find any trade-offs between different structures. This issue has been resolved.
● The MCO slider is working correctly again if only the lower point objective and
homogeneity objective are selected.
● The issue, where the surrogate IMRT fields used in the Hybrid VMAT MCO plan
generation were added with no collimation angle, has been resolved. If collimator angle is
used to extend the treatment field and cover a target that is longer than the machine
limits (MLC limit or primary collimation limit for Halcyon or Elekta BM), then the dose
calculated for target and OAR in Trade-off Exploration will be correctly taken into account.
● In Trade-Off Exploration, the combined slider for structure with a zero-priority objective
and another low priority objective is working correctly again.
Changes in Proton Planing

● In some cases, when using the NUPO for the optimization, the dialog gave the
impression to be frozen. This issue has been resolved.
● In previous version of Proton PT, if the maximum image size of a phantom for Proton
Convolution Superposition (PCS) was 256×256 pixels, it could introduce reduction of
calculation accuracy. The maximum image size has been changed to 1024×1024 pixels.
Changes in Printing
● When a calculation model is defined for an imported calculated plan, recalculation of the
plan is not required. However, in the print report, the selected calculation model was
reported while the plan was not calculated with that calculation model. This behavior has
changed, no calculation model information will be shown in the print report in this case.
This will also be the case for plans created in Cone Planning. Therefore, the print report
should be done from Cone Planning in case capturing the information on calculation
model is wanted.
● No incorrect warning about missing patient name/ID, course ID and plan ID will be given
anymore when selecting a custom treatment report, even when all that information is
present in either header/footer/main report.
● In the Full.tml treatment plan report, the defined structure codes of the structures are now
also included in the printout.
Changes in Beam Configuration

● When creating a new calculation model and selecting the Use same beam data as
existing calculation model option, it was possible to assign a calculation model to use
beam data that was not compatible with the calculation model. This issue has been
resolved.
● It is now possible again to import Acuros XB 15X preconfigured Golden Beam Data in
15.6 and 16.0 without any problems.
● The issue, where Beam Analysis crashed if the default technique for the machine used
in Beam Analysis was not set to “Static” in RT Administration, has been resolved.
● The issue, where the Beam Analysis workspace did not take into account if the
measurement direction of the beam profiles was configured to Collimator Y, has been

resolved. Beam Analysis now correctly shows the calculated beam profiles according to
the measurement direction.
● Disabled algorithms are no longer shown in the Context Window in Beam
Configuration. A disabled algorithm can be re-enabled so that it reappears in the tree
view of the Context Window.
● When configuring proton beams in Beam Configuration, for each option you need to
configure a minimal and maximal nominal energy for which the option is applicable. The
values must be between the maximum and minimum energies of the measurements,
including the maximum and minimum value.
● When configuring Acuros PT in Beam Configuration (for modulated scanning and
wobbling), the steering magnets need to be assigned and match the steering magnets
defined in RT Administration.
● For the IBA PCS and IBA NUPO configuration, the IGH support has been obsoleted
(IBA_iIndex, IBA_gIndex, IBA_hIndex, IBA_ScanAmplitude and IBA_ScanAngle).
Consequently, IBA “XSpecial” magnet option is no longer supported. The user will be
prompted to modify the option in Beam Configuration.
● In beam configuration for PCS and NUPO, the selection of the ionization chamber for the
depth dose curve has been modified:
● Modulated Scanning: use parallel plate chamber (only available option).
● All other techniques: use pin point chamber (only available option).
● In Beam Configuration for PCS and NUPO, when changing the ABC parameters of the
first gaussian, the following parameters will be invalidated and recalculation will be
needed: calculated spot fluence profiles X/Y, calculated size of beam spot X/Y, V
parameter. Changes in the ABC parameters of the second gaussian do not invalidate the
previous listed parameters.
● In Beam Configuration for PCS and NUPO, the parameter Distance from isocenter to
scatterer, is removed. This parameter was not used by the system for the beam
configuration.
● In Beam Configuration for PCS and NUPO, the parameter Isocenter to Monitor
Distance, is removed. For modulated scanning this value was used by the SAD factor:
(VSADX * VSADY) / ((VSADX - b) * (VSADY - b)) where b is the Isocenter to Monitor
Distance. When importing beam data from previous calculation model, the Isocenter to
Monitor Distance, is automatically removed. If this value was different than “0”
(recommended value), then the depth dose measurements will be automatically
converted (multiplied by the inverse of the SAD factor). For the other techniques this
parameter was not used.
Changes in Import / Export

● DICOM Import/Export allows to import 3rd party approved plans with the same plan ID.
It is now possible to change the plan ID, name and comments in Plan Parameters and
External Beam Planning.
● The user right Import/Export Workspace Filter Configuration does now correctly prevent
changing the import/export configuration in External Beam Planning if not assigned.
● Eclipse was resetting the viewing planes to the image center after exporting the dose
plane. This issue has been resolved. The viewing planes are kept after exporting dose
plane

● Exporting of dose line profile of two plans that were calculated with different calculation
grid size from Plan Evaluation workspace, works again correctly without crash.

Known Issues for Eclipse Treatment Planning
Known Issues for Eclipse Treatment Planning 16.0
Known Issues in RT Peer Review

● ARIA tasks not assigned to any patient, or assigned to the first patient of the RT Peer
Review session, might create unexpected behavior if active during an RT Peer Review
session:
● If there are multiple tasks on the ARIA worklist and the active task is completed, the
review session will be paused. In that case, the Resume option is available in the left
panel on the Patient Overview and can be selected to continue the review.
● If there is one task on the ARIA worklist and it is set to complete, the review session
will terminate without closing properly the review session. The review session can be
forced to finish by restarting RT Peer Review and selecting the option Force Finish.
● ARIA task completion is not linked to RT Peer Review status change.
Known Issues in Contouring, Registration and Smart Segmentation

● When contouring small volumes, use the tool to display contours on the previous and
next plane to make sure that contours are consistent from one slice to the other. When
the contours for small volumes are not consistent, this can affect the results of Photon
Optimization and dose calculation in External Beam Planning, and DVH calculations for
these structures. This is important when preparing a patient for HyperArc planning.
● The maximum number of CT slices that Smart Segmentation is able to process is 1024.
● In some cases, when using the Segmentation Wizard for lungs, the result might deviate
from the expected result. It is recommended to verify the contours and correct them
manually if necessary.
● If a user added an expert case for the tumor site prostate that has more than one
structure with the label CTV High Risk, and it is used for contouring a new patient, all
structures with the label CTV High Risk will have the same shape.
● Using the 2D static brush on two blended images A and B, where B is registered against
A with some pitch or yaw or both, the following might be observed:
● Wiggling of the brush shape while drawing.
● Unintended modification of the contour in the neighboring slices.
This is caused by a design limitation, when projecting the brush shape and the contours
to the slices of the registered image B that are not aligned to the transversal drawing
view. As the visualization of registered images is aligned to the target image (indicated by
the arrow of the registration object in the GUI), this limitation is observed when drawing
on the source image (tail of the registration object).
As a workaround, create an inverted copy of the registration (choose Registration >
Invert Registration) and select this inverted registration for contouring. An alternate
solution is to double-click the source image and draw contours in non-blended views.
Known Issues for Eclipse Treatment Planning 25

● The processing mode for the Post Processing tool is reset to 3D.
● Function to flip image Left/Right is no longer available.
● Pencil tool is not available in 4D player.
● Legacy images imported with inverted slice order (for instance, images in CadPlan CART
image format) are not supported.
● If one of the predefined couch structures is assigned to the patient and the couch
structure contains very thin layers, it might be possible that the thin layer will not be
completely drawn. This issue depends on the CT grid size and the position of the Body
structure. We advise to carefully check the automatically inserted couch structures and in
case they are not complete, to manually adjust the missing parts.
● When an already drawn structure is cleared from all planes while the Imaging Threshold
tool is open and the Imaging Threshold tool is then used in combination with a user
defined VOI, the parts that were originally outside that VOI will appear again when
clicking the Apply button. To avoid that, use the Clear from all planes function before
selecting the Imaging Threshold tool.
● Contouring, Registration and SmartAdapt do not allow entering window width and
window level directly. Windowing is possible only via widget displayed on a side of image.
● Contouring crashes if a structure is linked to an image belonging to another patient. If that
happens, such a structure can be deleted in External Beam Planning or Brachytherapy
Planning.
● When adding a couch structure to a CT data set, the body contour may disappear at the
first or last CT slice.
● MR Images with the OT modality instead of the MR modality are not displayed in
Contouring and Registration.
● There is an issue with the Image Threshold tool when using it for a structure that has
been already contoured and adjusting the VOI while having the Image Threshold tool
open to make the VOI smaller than the original structure. If in this case, the original
structure is cleared from all planes using the Clear from All Planes tool and the Imaging
Threshold tool is used, the parts of the original structure, which are outside the VOI, will
come back. It is recommended to first clear the structure from all planes, save, and then
use the Imaging Threshold tool for a newly selected VOI.
● If a structure contains two or more disconnected structure segments in one or more CT
slices, interpolation might produce suboptimal results. In such a case, it is recommended
to manually contour each slice or to copy-paste the structure from one CT slice into the
next one, and to manually adjust the structures.
● When using the Eraser tool to modify a structure in 2D mode, it is possible that very
small changes on the contour in the next and previous CT slide might happen. The
magnitude of those changes is in the range of the image pixel size. As a workaround, you
can use the Pencil tool to modify the structure in 2D.
● CT values assigned for structures are now converted to electron densities in the export of
structure sets by using the electron density calibration curve. Similarly, imported structure
electron densities are converted to stored CT values using the electron density calibration
curve. Differences in assigned CT values can still occur when structure sets with
assignments higher than 100 HU from Eclipse versions 11.0 or older are imported.
● Even if the combined structures have high resolution, the new structure created using an
automatic structure creation tool (for example the Boolean tool) will have low resolution. If

the target structure was already defined as a high-resolution structure, the resolution is
kept during the use of such a tool.
Known Issues in External Beam Planning

● In certain circumstances, when using Fit and Shield with arc arrangements, a field with
invalid gantry rotation is created. Under these conditions, the system will notify the
planner.
● The Skin Flash tool does not compensate for beam profile. If the tool is used with
unflattened beams, ensure that the dose fall-off in the flashed region is clinically
acceptable.
● Planning using a 3D image set that is created from a scanned 2D film (secondary capture
modality) is not supported in this version.
● If the QFix Calypso kVue Couch is added to a particular patient image in External Beam
Planning, in some cases it can happen that some parts of the thin top surface are
missing. When adding the QFix Calypso kVue Couch directly in Contouring, the issue is
not present.
● In previous versions, the step size in DVH Export Step was automatically updated when
switching from relative dose to absolute dose or vice versa. In the current version, this
value is not updated. The user can manually change the value.
● The control system RTT Syngo from Siemens only accepts beams with integer MU
values for conformal static arc fields and electron fields. To make sure that these fields
are planned with integer MU values, recalculate the plan using the Calculate Volume
with Preset Values tool.
● The Change Treatment Unit feature which can change a plan from one treatment unit to
another does not support partially treated plans. If a plan is partially treated, and the
Change Treatment Unit feature is used to create a new plan for another treatment unit
that is not within a Dosimetrically Equivalent Machine (DEM) group, a new full fraction will
need to be delivered. The partial treatment will need to be delivered on the original
machine.
● Splitting arc fields for verification plans may result in invalid leaf positions for the arc
subfields. Use full arc verification plan instead if this occurs.
● Reloading function in External Beam Planning will not refresh the Bookmark Manager
without closing the dialog box first. After reloading, close and open the Bookmark
Manager to access the most recent changes.
● DICOM Export does not export the MU values for Halcyon MV imaging fields with an
invalid (not calculated) plan dose.
● When sending contoured structures between two different systems through DICOM,
small changes in the contours can occur due to the use of different internal structure
models. Therefore, the contours should always be checked.
● The immobilization device and localization technique lists available in the Plan Setups
tab of clinical protocols cannot be edited anymore. Items defined in the previous version
in the list are kept and can be selected after upgrade.
● A duplicate plan is appearing when a plan is linked to an RT prescription and a clinical
protocol reference. Both plans are the same but shown twice. When you make changes
in one plan, the other plan will be updated accordingly.

Known Issues in Plan Converter
● The Plan Converter is not working when 23 MV and 25 MV energies are present in the
beam data folder of the selected AAA model. In addition, if an energy in the beam data
folder of the selected AAA model is not fully configured and approved, the Plan Converter
will not work.
Known Issues in Calculating, Viewing, and Evaluating Dose

● eMC uses the calculation volume to estimate the overall memory required, but in fact the
calculation volume has no influence on the overall memory consumption of eMC. In the
case that the calculation volume is smaller than the overall patient volume, the system
might run out of memory. As a workaround, the calculation volume can be increased to
match the patient volume, which will make sure that the correct number of parallel
servants which can be handled by the available memory are started.
● Smart LMC might for some fluences produce a leaf sequence where multiple neighboring
leaves line up at roughly the same position and remain almost stationary for long periods
of time in the middle of the fluence. When this leaf sequence is calculated, the actual
fluence matches the optimal fluence but plan QA might show a discrepancy with the
calculated dose in that area. As workaround, re-optimize the plan and perform a slight
collimator rotation for the field that shows the discrepancy.
Known Issues in Halcyon Treatment Planning

● When the Plan Creation wizard (Insert > New Plan) is used with the Halcyon treatment
device, the couch structures are automatically inserted to the plan. If the CT images
contain an ancillary patient support device, such as an angled breast board, the couch
structures may be inserted at an undesired position. When this is encountered, move the
couch structures manually (right-click the couch structure and select Move Support
structures, then click the couch structures in the axial view and drag to the desired
location).
● When the MLC Shape tool is used with the Halcyon treatment unit, which has no
collimator jaws, only shapes with an even numerical value can be created. If the user
inputs an odd value (for example, 3 cm), the system will create the shape with the next
available even value (such as 4 cm).
● If an imaging field was created for the Halcyon delivery device with the Margin to Target
Volume feature, and the target shape is edited in Contouring, the MLC shape in the
imaging field is updated when re-entering External Beam Planning. If the target shape
is edited only in External Beam Planning, the MLC shape of the imaging field is not
updated.
● The DVH Based Plan Converter does currently not support conversion from or to the
Halcyon treatment unit, and it is disabled for Halcyon-based treatment plans.
● Moving a single isocenter group in a multiple-isocenter plan for the Halcyon treatment
unit is only allowed in the longitudinal direction. If the user moves the group in other
directions (anterior–posterior, or left–right), all isocenter groups will be moved similarly.
● There are several issues when using the Change Treatment Units feature:
● Users may encounter an error “No fields” when attempting IMRT optimization after
change from Halcyon to a linac with either Millennium or HD120 MLC. This is
because the MLC is added with closed leaves during the change to prevent dose

calculation without optimization or leaf sequencing. Remove the MLC from each field
in order to optimize the plan.
● When performing a change from Halcyon treatment unit to a non-Halcyon treatment
unit for a treatment plan, the MLC leaves cannot be completely closed. In that case,
the conversion will fail. Open some of the MLC leaves before performing such a
machine change.
Known Issues in Cone Planning

● When the beam path is more than 30 cm from the entrance to the exit of the beam, a
warning message is displayed in Cone Planning: “Zero dose is set for points which are
further than 1300mm from the source; reduce SSD and restart the calculation for
complete dose coverage.” In prior versions, the user could edit the Body contour to
reduce the size/length. When the plan was recalculated, the warning message would
disappear. The warning does not disappear after the Body contour is edited and the plan
is recalculated. The user must create a new plan on the edited structure set to clear the
warning message.
● “Normalization isocenter” of Calculation Options for ECDC now only allows integer
values. Previously, a decimal value could be defined and stored to the database. This
change means that if the user has defined a decimal value for the “Normalization
isocenter” option for a plan before, now with 15.5, opening the same plan will result in an
empty “Normalization isocenter” value in the Calculation Options dialog box, since the
value is invalid. You can click OK, and the workflow will not be blocked. The DCF client
will also handle it as before—taking the integer part and using it for normalizing the dose,
as seen in the calculation log.
Known Issues in RapidPlan

● After the database upgrade, any Varian provided models that were published in the
previous version will be changed to unpublished.
Known Issues in Trade-Off Exploration

● During Trade-Off Exploration, it is sometimes possible to cause the system to show a
combination that is not pareto-optimal (that is, all objectives can be improved
simultaneously). This is a property of the solver used during navigation and may occur
when the user is consistently pulling the slider(s) in the direction which degrades the
objective (that is, more dose for an OAR, or less dose for target). Simply pulling the slider
in the “improve” direction will force the solution back onto the pareto boundary.
● Plan generation times for Trade-Off Exploration can vary widely depending on plan
complexity and technique, and is correlated to the number of objectives selected. There
are ~ 3 plans created for each objective selected. It may take as little as 30 seconds
(IMRT on GPU) or more than 1 hour (complex VMAT plan with many objectives using
native VMAT plan generation technique). The progress bar will initially progress very
slowly, but once the first set of plans have completed and have been added to the plan
collection, the bar will progress more steadily.
● During Trade-Off Exploration, it is possible to “extend” the possible range of improvement
for a given objective by pressing the arrow icon on the left side of the slider. However,
due to technical reasons related to restarting the optimizations, it is only possible to use

this feature during the initial Trade-Off Exploration. Users can return to the Trade-Off
Exploration dialog box and re-navigate with the sliders, but the “range extend” left arrow
icon is disabled.
● If leaf limits were used for the initial VMAT plan with either Elekta Beam Modulator or
Halcyon, Trade-Off Exploration does not take them into account when preparing the
Trade-off Plan collection and the navigation may be different than what can be realized
with the leaf limits in place.
● The hybrid optimization for VMAT trade-off plan generation is not supported for HyperArc
plans.
Known Issues in Proton Planning

● Distances to beam line modifiers are not exported in the DICOM RT Ion Plan.
● In DEM (Dosimetrically Equivalent Machine) change, not all layers of a static DRR are
removed in proton setup fields. Delete the static DRR and regenerate any layers
required.
● For the IBA proton system, special care needs to be taken (1) when configuring the beam
for the double scattering and uniform scanning, and (2) when editing the beam line.
● For long SOBPs, the 90% isodose may not completely cover the target at the
proximal end. This can be improved by fine tuning the beam configuration to enhance
the correspondence between calculation and measurements.
● IBA does not consider the Nominal Energy defined in Eclipse when selecting the
beam line parameters. After the beam line editing, the Nominal Energy and the
Nominal Range can be unrelated. If this is the case, the Nominal Energy used in
Eclipse for the dose distribution calculation can be different from the Nominal Energy
used by the IBA delivery system.
● Field-specific target: The snout shape and size affects the resulting field-specific target if
the base structure extends beyond the divergently projected snout shape and size. This
information is not stored with the field-specific target parameters, and thus Eclipse does
not notify the user if the snout is different than the snout that the field-specific target was
generated with.
● EAAPI for protons: It is responsibility of those who implement custom proton algorithms
using the EAAPI Compensator capability to ensure that predefined parts of the beamline
(modifiers, settings and other parameters) are properly accounted for in compensator
calculation or, in the case the algorithm does not support the compensator option, to
reject calculation with a proper error message.
● In rare cases it can happen that some spot positions are outside the field size limit
(rounding issue) and the proton machine will reject the plan. In such a case, the spots
that are outside the limit need to be manually modified.
● When Acuros PT is used for wobbling technique with a ridge filter, for some collimator
(snout) rotation angles the calculation will fail due to Eclipse client running out of memory.
You can slightly change the collimator (snout) angle and restart the dose calculation.
Known Issues in Printing

● To change the printer properties in a Fullscale 2.0 environment, the local settings button
in the client settings tab should be used and not directly the Layout or Paper/Quality tab.
When using the local settings button in the client settings tab, new tabs for Layout and

Paper/Quality will be shown, and only there the adjustments of the settings will be used
for the print-outs.
● When trying to print a PDF report or a view from Eclipse, nothing will be printed when
using Adobe X Pro PDF printer. The workaround is to use CutePDF v3.2 PDF printer.
Known Issues in Beam Configuration

● When configuring an Elekta motorized wedge in individual steps, it is not possible to
perform the “absolute dosimetry” or “correction factor table” steps unless the longitudinal
profile has been used for configuration. The value of the “Use longitudinal profile for
motorized wedge configuration” parameter in MW parameters needs to be set to “Yes”,
and the “scatter and transmission” step needs to be completed, otherwise the two
subsequent steps finish unsuccessfully. It is still possible to configure the motorized
wedge with or without the longitudinal profile configuration using the “configure all steps”
option.
● The following message “Not enough measured field sizes” will be displayed in Beam
Configuration if a minimum of 3 field sizes between 40.5 and 200.5 mm has not been
entered for PO and DVO. To clear the message, additional data needs to be entered
between the field sizes of 40.5 and 200.5 mm.
● Cobalt beam data cannot be reconfigured from older beam data for AAA algorithm. When
recalculating, an error message regarding incompatible version of the Varian photon
beam source model configuration will be given. As workaround, delete manually the
'Fluence Profile' in the configuration before recalculating beam data.
● When creating a new proton calculation model and selecting the Use same beam data
as existing calculation model option, it is possible to assign a calculation model from a
different version of the same algorithm that is not compatible with the newest version of
that algorithm.
Known Issues in Conformal Optimization, Biological Optimization, and

Biological Evaluation
● Currently in Biological Evaluation, it is possible that structures are outside of the dose
matrix, or only partially covered, and there is no warning that the calculated DHV is not
correct/complete. Ensure that the dose matrix covers each structure entirely.
● It is possible that the “Optimization Result” dialog may be hidden behind another
workspace and not in front of the Conformal Optimization workspace or Biological
Optimization workspace. The dialog is as well not present in the task bar. In this case,
use the Alt+Tab key to find the “Optimization Result” dialog to bring it to the front again.
Known Issues in Eclipse Scripting API

● It is not possible to start optimization from zero via ESAPI.
● It is not possible to calculate proton DDC via ESAPI.

Miscellaneous Known Issues
● Be careful not to change a treatment plan on a workstation while it is being calculated in
another Eclipse session on the same workstation or on another workstation. When plans
have been edited concurrently, always verify the final state of the plan information.
● In a very specific circumstance, the Assistant Bar may show a different patient ID/name
than the patient that is currently loaded in the application. The user is asked to always
verify the patient ID/name in the title bar and in the Object Explorer to ensure the
expected patient is selected.

Performance Information
Performance Information for Eclipse

Note: Do not install any third-party software, or updates to the operating system without
instructions from Varian Medical Systems. Eclipse has been validated on the operating system
listed in this Customer Release Note. Varian does not guarantee normal performance of the
software when non-validated third-party software is installed on the system, because the
installation may modify the operating system components used by Eclipse. For more
information on Varian’s policy regarding the installation of third-party software on workstations
pre-loaded with Varian Medical Systems Software products, refer to Customer Technical
Bulletin CTB-GE-534, and to section “Compatible Software Applications” in this Customer
Release Note.
● Eclipse and BrachyVision should be operated by qualified personnel only.

● Configure the short-date format for your Windows operating system to display the month
and year in an unambiguous manner (for example, dd-MMM-yyyy). Eclipse has been
validated using regional settings for English (United States). The date format used in the
application depends on these operating system settings.
● Check all media and data files before you use them on a computer that is used to run
Eclipse. Computer viruses can cause corruption of data files and adverse effects in
software that run on computers infected by a computer virus. For more information on
appropriate virus protection, refer to Customer Technical Bulletin CTB-GE-309 (Varian
Medical Systems Anti-Virus Software Policy).
● If you add your computer to a network, make sure that the network is secure or that the
passwords used to access the computer are not compromised. Unauthorized users that
gain access to your system can cause damage to your system.
● Back up your system regularly. The patient database, including image directories, should
be backed up routinely.
● Plan report templates from Eclipse 6.5, builds 7.3.10, and earlier are not supported in this
version of Eclipse. New report templates are installed with the new version. If customized
report templates were created at your clinic, they will not be available after the upgrade
unless they are copied to the appropriate location. Varian personnel will not perform that
task. If such customized report templates are made available in Eclipse 15.5 or newer it
is the customer's responsibility to verify that they work properly.
● All installed printers should be tested at the customer site to make sure that printing
works as expected and all of the required information is available on the printouts.
Using Within a Citrix Environment

● For HyperArc-planning, only Citrix server version 7.6 and higher is supported. The 3D
animation of the Virtual Dry Run will not run when using a lower Citrix server version.
● The Citrix server version 6.5 supports only one selected NLS version.
Note: For additional information on the use of Citrix with Eclipse and BrachyVision Treatment
Planning, refer to the ARIA/Eclipse technical specifications available on myvarian.com.
Performance Information 33
User Documentation and Support
Related Publications
User Documentation
The user documentation for this version of Eclipse Treatment Planning includes:
● DICOM Import and Export Reference Guide, P1034778
● Beam Configuration Reference Guide, P1026479
● Biological Modeling Reference Guide B502697R01A
● Biological Optimization, Biological Evaluation, Conformal Optimization Instructions for
Use, B503586R01A
● Dosimetric Review Reference Guide (Plan Parameters Workspace), P1026483
● Eclipse Algorithm API Reference Guide P1034169
● Eclipse Photon and Electron Algorithms Reference Guide, P1026471
● Eclipse Ocular Proton Planning Reference Guide, P1005367
● Eclipse Scripting API Reference Guide, P1026484
● Eclipse Scripting API Online Help, P1026485
● Eclipse Proton Algorithms Reference Guide, P1026475
● Eclipse Proton Algorithms Reference Guide – ProBeam, P1026476
● RT Administration Reference Guide, P1026480
● Image Registration and Segmentation Instructions for Use, P1036224
● Image Registration and Segmentation Algorithms Reference Guide, P1038042
● Image Registration and Segmentation Scripting API Reference Guide, P1020793
● RT Summary Reference Guide, P1034775
● Eclipse Photon and Electron Instructions for Use, P1026458
● Eclipse Photon and Electron Reference Guide, P1026470
● Eclipse Proton Instructions for Use, P1026477
● Eclipse Proton Reference Guide, P1026478
● Treatment Preparation Reference Guide, P1034774
● Varian Service Portal Administration Reference Guide, P1014877
● Varian Service Portal User Rights Reference Guide, P1037207
● Varian Oncology Services Reference Guide, P1025492
Contact Customer Support

For user documentation or customer support, go to www.MyVarian.com.

Eclipse 16.0 Treatment Planning Customer Release Note

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Eclipse Treatment Planning

Customer Release Note

P1038089-002-B DECEMBER 2019

FDA 21 CFR 820 Quality System Regulations (cGMPs)

2 Eclipse Treatment Planning Customer Release Note

EU REACH SVHC Disclosure

International Organization for Standardization ISO 13485

Authorized Representative in the EU

Legal Information ........................................................................................................................................ 2

System Components and Compatibility ..................................................................... 8

System Requirements ................................................................................................ 10

New Features and Enhancements ............................................................................. 11

Changes from the Previous Release ........................................................................ 16

4 Eclipse Treatment Planning Customer Release Note

Known Issues for Eclipse Treatment Planning ........................................................ 25

Performance Information ........................................................................................... 33

User Documentation and Support ............................................................................ 34

About Eclipse Treatment Planning

WARNING: In Eclipse and/or BrachyVision integrated with ARIA Radiation Therapy

WARNING: It is recommended to verify and confirm the patient setup with an

6 Eclipse Treatment Planning Customer Release Note

Compatible Software Applications

8 Eclipse Treatment Planning Customer Release Note

System Components and Compatibility 9

Recommended System Requirements

10 Eclipse Treatment Planning Customer Release Note

New Features and Enhancements in Eclipse Treatment Planning

New Features in Contouring, Registration and SmartSegmentation

New Features and Enhancements 11

New Features in Halcyon Treatment Planning

New Features in Clinical Goals and Clinical Protocols

12 Eclipse Treatment Planning Customer Release Note

New Features in Photon Optimization

New Features in RapidPlan

New Features and Enhancements 13

New Features in Trade-off Exploration

New Features in Proton Planning

New Features in Eclipse Scripting API

14 Eclipse Treatment Planning Customer Release Note

New Features in Concurrent Editing

New Features and Enhancements 15

Changes in Eclipse Treatment Planning 16.0

Changes in Contouring, Registration and SmartSegmentation

16 Eclipse Treatment Planning Customer Release Note

Changes in External Beam Planning

Changes from the Previous Release 17

Changes in Clinical Protocols and Templates

Changes in DRRs and Structure Outlines

18 Eclipse Treatment Planning Customer Release Note

Changes in the Freehand Tool

Changes in Field-in-Field Technique

Changes in Planning for Elekta

Changes from the Previous Release 19

Changes in Halcyon Treatment Planning

Changes in IRREG Planning

Changes in Cone Planning

20 Eclipse Treatment Planning Customer Release Note

Changes in Trade-Off Exploration

Changes from the Previous Release 21

Changes in Proton Planing

Changes in Beam Configuration

22 Eclipse Treatment Planning Customer Release Note

Changes in Import / Export