Introduction of Near Field Communication for file sharing system in radiotherapy

doi:10.21203/rs.3.rs-3240104/v1

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Introduction of Near Field Communication for file sharing system in radiotherapy

https://doi.org/10.21203/rs.3.rs-3240104/v1

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Near Field Communication (NFC) is an extension of radio frequency identification (RFID) technology, enabling contactless wireless communication for easy and quick access to specific information. In this study, we aim to assess the NFC capability in the radiotherapy department and develop a file sharing system using NFC tags. We utilized the battery-less NFC tag (MM-NFCT, SANWA SUPPLY INC., Okayama, Japan), which can be placed anywhere due to its sealed one side. We uploaded various types of files and movies to be shared on Google Drive, and the sharing URL was stored in the NFC tag using a NFC application. We also provided examples of utilizing the NFC tag and examined suitable document types for sharing in the radiotherapy department. Additionally, we investigated 28 smartphones for NFC technology compatibility. Manually describing treatment planning procedures and institution-specific margin recipes of planning target volume in each tumor site is suitable for sharing via the NFC tag. By placing the NFC tag at work locations, simply touching it with a smartphone grants immediate access to these documents for confirmation. Regarding smartphone compatibility with NFC tags, 25 out of 28 individuals (approximately 89%) were able to identify the NFC tag. The NFC technology is introduced at a low cost for work efficiency. It is useful to quickly access desired information in a radiotherapy department, such as treatment planning manuals and checklists. The NFC system allows for the development of a specific-institution radiotherapy environment, enabling the sharing of various documents and NFC tag placements as desired.

Radiotherapy

NFC

QR code

radiotherapy

Radio frequency identification (RFID) technology and quick response (QR) code are widely used in everyday life, including digital wallets, ticket purchases, application launches, and home appliance control. Smartphones have become an essential part of daily life, and these technologies have also been introduced in healthcare for patient management [1–3]. Near Field Communication (NFC) is an extension of RFID technology [4], enabling wireless contactless communication for easy access to specific information. NFC allows for identification of tags by smartphones and can store limited data, providing intuitive and convenient access to desired information without the need for special devices.

This study aimed to assess the NFC capability in the radiotherapy department and develop an NFC-based file sharing system. We present example cases to demonstrate the efficiency of NFC in daily work.

NFC operates on the 13.56 MHz frequency band, following the ISO/IEC 14443 standards, allowing data communication between the NFC tag and a smartphone [5]. Figure 1 illustrates that the smartphone can identify the NFC tag at a distance of a few centimeters, enabling quick access to prerecorded data. It takes about several seconds for access. If the NFC tag stores URL information, the smartphone’s browser can display the URL, which can be accessed by simply touching the screen. It is important to note that NFC communication is not possible on metal objects due to interference. Therefore, NFC tags should not be placed on metal objects.

For this study, we utilized the battery-less NFC tag (MM-NFCT, SANWA SUPPLY INC., Okayama, Japan) with a diameter of 22 mm and a thickness of 0.184 mm. These NFC tags can be placed anywhere except on metal objects and cost approximately a few dollars per tag. Each NFC tag has a memory capacity of 144 bytes, allowing for limited data storage. Figure 1 provides an overview of the file sharing system using NFC tags. We uploaded various types of files to be shared on Google Drive and stored the sharing URL in the NFC tag using a dedicated NFC application. This method enables easy and quick access to necessary information during daily work. To comply with our security policy, the documents stored in the NFC tags did not include clinical information but were associated with technical documents such as treatment planning procedures. We examined the appropriate types of documents for radiotherapy in two main areas: treatment planning and quality assurance (QA) machine procedures.

We also assessed the compatibility of staff’s personal smartphones with NFC communication. The examination was conducted in July 2023, and a total of 28 smartphones were tested. It is important to note that the use of personal smartphones should comply with institutional security policies. In this study, we focused on the access capability of personal smartphones, but it may be necessary to consider dedicated smartphones for this purpose. We provided examples of utilizing NFC tags, including the placement of NFC tags on the extension platform of the monitor for treatment planning (refer to Fig. 2). The extension platform was created using a 3D printer (F170, Stratasys, MN, USA), and the 3D design was generated using a three-dimensional computer-aided design (3D CAD) tool called Tinkercad.

New technologies like QR codes, NFC tags, and barcodes [6] have significant potential for enhancing safety and efficiency in healthcare. Barcodes, for example, can be used for patient or radiotherapy accessory/device identification and have been proven effective in quality management in radiotherapy [6, 7]. However, the development of QR codes and NFC tags for identification and verification purposes in radiotherapy is still in progress. This study focuses on discussing the benefits of implementing NFC technology and provides examples of its application.

Table 1 shows appropriate types of technical documents for file sharing using NFC tags in the radiotherapy department. In treatment planning, manuals and institution-specific margin recipes for internal target volume (ITV) and planning target volume (PTV) in different tumor sites are suitable for sharing via NFC tags. This enables early detection of any misunderstandings in treatment planning by quickly referring to these documents. Checklists are also valuable for identifying improper treatment directives and human errors in operational mistakes during chart and treatment plan review [8, 9]. From a clinical perspective, radiation oncologists often refer to TNM classification or ATLAS delineations.

Table 1

Appropriate type of technical documents or movies for file sharing using NFC tags at radiotherapy departments. The URL of the following documents is stored in NFC tags.
Treatment planning
	Treatment planning procedure	Institutions may have their own planning procedures, and this is often referred to for treatment planning.
	TNM classification	This is often referred for confirmation.
	ATLAS for contouring	This is often referred for delineation.
	Dose constraints in organs	The common dose constraints should be used in the institution.
	Margin recipes of ITV and PTV	Geometrical margin of ITV and PTV is dependent on institution. To prevent planner’s misunderstanding, the on recipes should be referred in the institution.
	Checklists [8, 9] for treatment plan and chart review	The checklist is effective in case of many items that should be checked.
Machine QA
	QA program	QA program is dependent on institutions. Institutional QA program and procedure should be referred immediately.
	Dose output calibration	In general, this test is performed monthly [10, 11]. The correct procedures should be repeated. It is desirable to have an environment in which the staff in charge can immediately check the procedure. The video of the procedure may be effective.
	QA procedure for treatment machine	Staff may not be familiar with infrequent QA such as annual QA items like Winston-Lutz or starshot test. The video of the procedure may be effective.

To enhance efficiency, it is recommended to include the sharing URL in frequently referenced documents. Alternatively, if there are numerous documents to be shared, the sharing URL of the folder can be stored in the NFC tag instead of each individual document. NFC tags can be placed anywhere, allowing staff to access documents or related videos at their work location (e.g., dose output calibration and machine QA) (Fig. 2b).

Regarding smartphone compatibility with NFC tags, 25 out of 28 individuals (approximately 89%) were able to identify the NFC tag and access the URL using their own smartphones without any technical issues. The smartphones that were unable to work were older models.

NFC tags have unique characteristics, including a battery-less design, and the ability to store information repeatedly. By sealing one side of the NFC tag, it can be placed anywhere with a thickness of about a submillimeter. When a label tape was placed on the NFC tag (see Fig. 2a), no issues were observed. The cost of NFC tags is typically several dollars, making it feasible to develop a sharing system tailored to institutional radiotherapy requirements.

QR (Quick Response) codes are another contactless device alternative. They can be scanned using a smartphone camera to identify the URL, similar to NFC technology. However, utilizing QR codes requires launching the camera and adjusting the focus on the code, involving slightly more steps compared to NFC tags. Additionally, QR code identification is dependent on ambient light, making it unsuitable for dark rooms.

One limitation of this study is that the effectiveness of implementing NFC tags in terms of improving staff efficiency or reducing human errors in operational mistakes during treatment planning was not demonstrated. It is important to investigate these aspects through long-term experiences and usage.

Battery-less NFC tags can be introduced at a low cost for work efficiency, and it is useful to quickly access desired information in a radiotherapy department, especially for treatment planning, and machine QA. The NFC system allows to develop environment to accommodate specific-institution radiotherapy; sharing any documents and any placements of NFC tags are possible, as desired.

RFID: radio frequency identification

QR: quick response

NFC: Near Field Communication

QA: quality assurance

ITV: internal target volume

PTV: planning target volume

Ethical Approval and Consent to participate

Not applicable

Consent for publication

Not applicable

Availability of supporting data

Not applicable.

Competing interests

The authors declare that they have no competing interests

Funding

We purchased the NFC tags by the National Cancer Center Research and Development Fund (2022–A–18).

Authors' contributions

C.T., N.M., N.S., I.K., N.H., S.Y., and T.Y. provide technical advice in this study. K.Y., K.H., U.Y., N.S., M.K., and I.H. investigated appropriate types of technical documents or movies for file sharing using NFC tags in radiotherapy departments. All authors read and approved the final manuscript.

Acknowledgements

Not applicable.

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No competing interests reported.

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Introduction of Near Field Communication for file sharing system in radiotherapy

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