At IRCCS Sacro Cuore Don Calabria Hospital, Prof Luca Nicosia and Dr Nicola Bianchi lead a high-volume radiation oncology program, treating over 2,000 patients annually. The department operates across a diverse technology landscape, including MR-guided, adaptive, and conventional linear accelerators, enabling them to manage a wide range of complex clinical scenarios.
Recently, the team has placed increased focus on how delivered dose is evaluated in the context of anatomical change within conventional treatment pathways. As case complexity has grown, they identified a need to better understand how dose evolves over the course of treatment, beyond what traditional verification methods could provide.
Since implementing ChartCheck Adaptive in early 2026, their approach has centered on strengthening treatment evaluation while maintaining efficiency within a busy clinical environment. Traditional chart checks and periodic reviews were not sufficient to capture day-to-day variations in dose delivery, particularly in anatomically changing patients.
“We needed a better way to understand delivered doses over time, especially in anatomically changing patients. ChartCheck Adaptive provides a clear, automated, and quantitative assessment without adding unnecessary manual workload," says Prof Nicosia.
Implementation was smooth, with straightforward integration into existing systems and strong support throughout the process. “The setup and onboarding process were very smooth. The Radformation team provided excellent support, helping us tailor the system to our clinical needs.”
ChartCheck Adaptive fits naturally into the clinical workflow. Operating in the background, it automatically processes data and presents results in a clear and accessible format. Notifications within the treatment planning system, alongside email alerts, enable rapid identification of patients requiring review without adding manual burden.
The impact on the physics team has been notable. Routine manual checks are reduced, allowing physicists to focus on trend analysis and earlier identification of potential issues. This supports a more proactive approach to quality assurance.
Feedback from radiation oncologists has been strongly positive, particularly in cases where anatomical changes may influence dose distribution. “The availability of cumulative and daily dose information increases confidence in treatment delivery and supports more informed clinical decision-making.”
Even in its current retrospective use, the team has already identified meaningful insights. Dose deviations linked to anatomical changes have been highlighted in ways that would have been difficult to quantify using conventional methods. This work is now supporting efforts to better understand variability and inform future clinical decision-making.
ChartCheck Adaptive has also improved efficiency in retrospective case review. The ability to analyse delivered dose across entire treatment courses has enhanced understanding of past treatments and helped identify patterns to inform future workflows.
Access to daily and cumulative dose data is already strengthening confidence in treatment evaluation and building a foundation for future clinical use. “Having quantitative data allows us to validate past clinical decisions and better understand the dosimetric impact of anatomical changes.”
The team highlighted the automated accumulation and visualization of delivered dose as a key strength, enabling efficient identification of trends and deviations. “The balance between automation and actionable insight is particularly well executed.”
Their experience working with Radformation has been consistently positive. “Our experience working with Radformation has been excellent. The team has been highly responsive, collaborative, and attentive to feedback.”
Through this collaboration, the team continues to explore the clinical potential of ChartCheck Adaptive, with a clear focus on improving confidence, consistency, and insight in treatment evaluation.