Workflow management system, radiation therapy system, and workflow management method

Abstract

To reduce a time required for online adaptive therapy.SOLUTION: A workflow management system is configured to execute a plurality of processes to perform radiation therapy in accordance with a predetermined workflow, the processes including at least a first process and a second process. The workflow management system concurrently executes a first module (a) which is included in the first process, displays a result of a first calculation based on a patient image captured during the therapy by an imaging apparatus for imaging a predetermined area of a patient, and requests an input by an operator, and a second module (b) which is included in the second process and executes a second calculation based on the patient image captured during the therapy.SELECTED DRAWING: Figure 4

Description

Technical Field

[0001] The present invention relates to a workflow management system, a radiation therapy system, and a workflow management method.

Background Art

[0002] The present invention relates to a workflow management system, a radiation therapy system, and a workflow management method applied to a radiation therapy system that treats a diseased part such as a tumor by irradiating it with radiation such as a particle beam.

[0003] A method of irradiating a patient with radiation such as a particle beam or an X-ray is known. Particle beams include a proton beam and a carbon beam. The radiation therapy system used for irradiation forms a dose distribution suitable for the shape of a target such as a tumor in the body of a patient fixed on a patient bed called a couch.

[0004] The condition of a patient's body, such as a change in the shape of a target or a change in a gas pocket in the intestine, changes daily. In order to improve the irradiation accuracy, adaptive treatment that reconstructs a treatment plan according to the condition of the patient's body on the treatment day has begun to spread. In particular, treatment that replans a treatment plan with the patient fixed on a couch on the treatment day is called online adaptive treatment.

[0005] As an example of a workflow of online adaptive radiation therapy that reconstructs a treatment plan on the spot according to the condition of a patient's body on the treatment day, Patent Document 1 discloses acquiring a command representing a treatment plan, using the command to gradually generate a patient model, generating first and second treatment plans, and automatically executing steps of selecting a treatment plan. A workflow of online adaptive treatment is described.

Prior Art Documents

Patent Documents

[0006]

Patent Document 1

Summary of the Invention

Problems to be Solved by the Invention

[0007] Patent Document 1 described above describes an automatic workflow for online adaptive treatment. In this workflow, patient fixation, imaging, contour creation, treatment plan creation and selection, and irradiation are sequentially performed. In conventional treatment, treatment is performed in three steps: patient fixation, imaging, and irradiation. However, in online adaptive treatment, since the number of tasks increases, the treatment time may increase.

[0008] The present invention has been made in view of the above problems, and an object thereof is to provide a workflow management system, a radiation therapy system, and a workflow management method capable of performing online adaptive treatment in a short time.

Means for Solving the Problems

[0009] In order to solve the above problems, for example, the configuration described in the claims is adopted. That is, a workflow management system that executes a plurality of processes to be performed for radiation therapy according to a predetermined workflow, wherein the plurality of processes include at least a first process and a second process, and the workflow management system is characterized by executing the following modules (a) and (b) in parallel. (a) A first module included in the first process, which displays the result of a first calculation based on a patient image captured during treatment by an imaging device that captures a predetermined region of the patient and requests an operator input. (b) A second module included in the second process, which executes a second calculation based on the patient image during the treatment.

Effects of the Invention

[0010] According to the present invention, the time required for online adaptive treatment can be reduced.

Brief Description of the Drawings

[0011]

Figure 1

Figure 2

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MODE FOR CARRYING OUT THE INVENTION

[0012] Hereinafter, embodiments of the present invention will be described with reference to the drawings. The following description and drawings are examples for explaining the present invention, and for the sake of clarity of explanation, omissions and simplifications are made as appropriate. The present invention can be implemented in various other forms. Unless otherwise particularly limited, each component may be singular or plural.

[0013] In the drawings for explaining the embodiments, the same reference numerals are given to portions having the same function, and the repeated explanation thereof is omitted.

[0014] The positions, sizes, shapes, ranges, etc. of the respective components shown in the drawings may not represent the actual positions, sizes, shapes, ranges, etc. in order to facilitate the understanding of the invention. For this reason, the present invention is not necessarily limited to the positions, sizes, shapes, ranges, etc. disclosed in the drawings.

[0015] When there are a plurality of components having the same or similar functions, they may be described by attaching different subscripts to the same reference numeral. However, when it is not necessary to distinguish these plurality of components, the subscripts may be omitted in the description.

[0016] As shown in FIG. 1, the radiation therapy system 1 according to the embodiment includes a workflow manager 10, a patient positioning system 11, a contour creation system 12, a replanning system 13, a patient verification (QA: Quality Assurance) system 14, an imaging device 20, an imaging control device 21, an irradiation device 30, an irradiation control device 31, a rotating gantry 40, a gantry control device 41, a couch 50, and a couch control device 51.

[0017] The bed on which the patient 60 is placed is called a couch 50. The couch 50 can move in three orthogonal axis directions based on an instruction from the couch control device 51, and can further rotate about each axis. By these movements and rotations, the position of the target 61 can be moved to a desired position.

[0018] Based on an instruction from the imaging control device 21, the imaging device 20 measures three-dimensional images of the patient 60 and the target 61 fixed to the couch 50. The three-dimensional images are CT images, cone beam CT images, or MRI images.

[0019] Based on an instruction from the irradiation control device 31, the irradiation device 30 generates radiation used for treatment. Specifically, by controlling the energy, irradiation position, and irradiation dose of the radiation, a desired dose distribution is formed for the target 61. A part of the irradiation device 30 is installed on the rotating gantry 40 and can rotate together with the rotating gantry 40. The rotating gantry 40 is moved to a desired angle based on an instruction from the gantry control device 41. By changing the angle of the rotating gantry 40, radiation can be irradiated from a desired angle.

[0020] Based on a pre-generated reference image and the three-dimensional images measured by the imaging device 20, the patient positioning system 11 calculates the position correction amount of the patient 60 with respect to the irradiation device 30. The operator 70 checks the calculation result and determines the position correction amount. Based on the determined position correction amount, the installation position of the couch 50 is calculated and set in the couch control device 51.

[0021] The contour generation system 12 generates a synthetic CT image for replanning based on a pre-generated reference image and a three-dimensional image measured by the imaging device 20. Further, the regions of the target and normal tissues are specified on the synthetic CT image, and their contour data is created. The operator 70 checks the calculation results, makes corrections if necessary, and then approves the synthetic CT image and the contour data.

[0022] The replanning system 13 optimizes the radiation irradiation parameters based on the synthetic CT image and the contour data to create a daily plan. Further, the dose distributions of the pre-generated original treatment plan (hereinafter referred to as the original plan) and the daily plan are compared and displayed. The operator 70 selects the treatment plan to be used for the treatment on that day.

[0023] The patient QA system 14 verifies the daily plan, and the operator checks and approves the verification results.

[0024] The workflow manager 10 is connected to the imaging control device 21, the irradiation control device 31, the gantry control device 41, the couch control device 51, the patient positioning system 11, the contour generation system 12, the replanning system 13, and the patient QA system 14, and monitors and manages the progress of the treatment workflow.

[0025] Here, the workflow management system of this embodiment includes at least the workflow manager 10, and further includes the patient positioning system 11, the contour generation system 12, the replanning system 13, and the patient QA system 14.

[0026] FIG. 2 is a schematic configuration diagram showing the workflow manager 10 according to the embodiment.

[0027] As shown in FIG. 2, the workflow manager 10 includes an input device 101 for inputting various parameters and the like, a display device 102, a memory (storage medium) 103, a database (storage medium) 104, an arithmetic processing device 105 (a control device which is an arithmetic element) for creating a workflow and monitoring and managing the progress of the workflow, and a communication device 106.

[0028] The workflow manager 10 is composed of a device capable of various information processes, such as an information processing device such as a computer as an example.

[0029] The arithmetic element is, for example, a CPU (Central Processing Unit), a GPU (Graphic Processing Unit), an FPGA (Field-Programmable Gate Array), etc. The storage medium has, for example, a magnetic storage medium such as an HDD (Hard Disk Drive), a semiconductor storage medium such as a RAM (Random Access Memory), a ROM (Read Only Memory), an SSD (Solid State Drive), etc. Also, a combination of an optical disk such as a DVD (Digital Versatile Disk) and an optical disk drive is also used as a storage medium. In addition, known storage media such as magnetic tape media are also used as storage media.

[0030] Programs such as firmware are stored in the storage medium. When the workflow manager 10 starts operating (for example, when the power is turned on), programs such as firmware are read from this storage medium and executed to perform overall control of the workflow manager 10. Also, in addition to programs, data etc. necessary for each process of the workflow manager 10 are stored in the storage medium.

[0031] Alternatively, some of the components constituting the workflow manager 10 may be connected to each other via a LAN (Local Area Network), or may be connected to each other via a WAN (Wide Area Network) such as the Internet.

[0032] Also, although illustration is omitted, various devices and systems constituting the radiation treatment system 1, such as the patient positioning system 11 etc., are also composed of information processing devices such as a computer.

[0033] FIG. 3 shows the basic concept of workflow management performed by the workflow manager 10 and the like of this embodiment.

[0034] The workflow manager 10, the patient positioning system 11, etc. perform each process of patient positioning, contour creation, replanning, patient QA, and irradiation, similar to general online adaptive treatment. The feature of the radiotherapy system of this embodiment is that during the execution of steps that require the judgment and operation of the operator 70, such as confirmation and correction of calculation results within each process, the calculation of the next process is started. If there is no correction of the calculation result by the operator 70, the calculation that has been started previously is continued. If there is a correction of the calculation result by the operator 70, the calculation that has been started previously is aborted, and the calculation of the next process is started reflecting the corrected calculation result.

[0035] The workflow manager 10 manages the steps executed within each process as modules divided by element.

[0036] FIG. 4 shows an example of a workflow managed by modules. Among the entire workflow, the range surrounded by a broken line indicates each process. Among each process, the modules automatically executed are indicated by a dotted line, and the modules that require implementation (i.e., manual implementation) by the operator 70 (i.e., judgment and operation) are indicated by a solid line. The modules that require implementation by the operator 70 are implemented after waiting for the judgment and operation by the operator 70.

[0037] Before the start of treatment, the workflow manager 10 holds CT images, contour data, irradiation parameters, dose distribution indices, and clinical goals as information on the original plan created during the treatment preparation period.

[0038] The workflow is composed of a positioning process P1, a contour creation process P2, a replanning process P3, a patient QA process P4, and an irradiation process P5. Software modules that execute each step of the positioning process P1, the contour creation process P2, the replanning process P3, and the patient QA process P4 are respectively held by a patient positioning system 11, a contour creation system 12, a replanning system 13, and a patient QA system 14, and are executed by their respective patient positioning systems 11 and the like.

[0039] The workflow manager 10 monitors the execution status of each software module executed by these patient positioning systems 11 and the like, and receives the execution results (calculation results) and execution end notifications of the software modules as necessary. If a certain step is completed, the workflow manager 10 identifies the next step according to the workflow, and instructs the software module of the patient positioning system 11 and the like to start this step.

[0040] Hereinafter, the workflow management method will be described for each process.

[0041] In the positioning process P1, in step S101, the operator 70 fixes the patient 60 to the couch 50. Further, in step S102, the operator 70 adjusts the position of the couch 50 to roughly position the patient 60 with respect to the irradiation device 30 based on a laser marker (not shown).

[0042] In parallel with steps S101 and S102, in S103, the imaging conditions of the imaging device 20 are set by the workflow manager 10. The imaging conditions are set based on information about the patient 60, the treatment site, and the previous treatment date.

[0043] In step S104, the three-dimensional images of the patient 60 and the target 61 on the current day are measured. In step S105, based on the three-dimensional image on the current day with the CT image of the original plan as a reference image, the position correction amount of the patient 60 with respect to the irradiation device 30 is calculated. When step S105 is completed, step S106 and S201 of the contour creation process P2 are executed.

[0044] In step S106, the operator 70 is requested to approve the calculation result. The operator 70 checks the calculation result and corrects the position correction amount of the patient 60 as necessary. If the position correction amount is corrected by the operator 70, the calculations being executed in the contour creation process P2 are discarded, and based on the corrected position correction amount, the process is executed again from step S201. If the position correction amount is approved in step S106, the position of the couch 50 is corrected in step S107. Also, the workflow manager 10 inputs information to the software module that executes step S208 indicating that the positioning process P1 is completed.

[0045] In the contour creation process P2, first, in step S201, based on the CT image of the original plan and the information of the treatment site, the calculation conditions for deformable image registration (DIR) are set. In step S202, based on the set calculation conditions, using the same-day CT three-dimensional image as the reference image, the CT image of the original plan is deformed by non-rigid registration to calculate a deformable vector field (DVF). In step S203, using the calculated DVF, a synthetic CT (sCT) image is generated by replacing the pixel values of the same-day three-dimensional image with the pixel values of the CT image of the original plan.

[0046] When step S203 is completed, steps 204 and S205 are executed. In step S204, the contour of the normal tissue is calculated based on the synthetic CT image and the DVF. In step S205, the contour of the target is calculated based on the synthetic CT image and the DVF. Steps S204 and S205 may be executed simultaneously or sequentially. When executed sequentially, the subsequent steps may be executed using the calculation result of the previously executed step.

[0047] When steps S204 and S205 are completed, step S206 and S301 of the replanning process P3 are executed. In step S206, based on the CT image and contour data of the original plan and the information of the treatment site, the calculation conditions for contour verification are set. In step S207, a calculation for verifying the contour data generated in steps S204 and S205 is executed based on the CT image and contour data of the original plan and the information of the treatment site.

[0048] In step S208, the synthetic CT image, contour data, and contour verification results are displayed, and the operator 70 is requested to approve the contour. The operator 70 checks the calculation results and modifies the contours of the normal tissue and the target as necessary. If the contour is modified by the operator 70, the calculations being executed in the replanning process P3 are discarded, and based on the modified contour, it is executed again from step S301. If the contour is approved in step S208, the workflow manager 10 inputs information that the contour creation process P2 is completed to the software module that executes step S306. Note that step S208 is not executed unless information that the positioning process P1 is completed is input.

[0049] In the replanning process P3, first, in step S301, based on the irradiation parameters, dose distribution indices, and clinical goals of the original plan, the conditions for optimizing the irradiation parameters are set. Here, the conditions are the dose distribution shape, DVH (Dose Volume Histogram) indices of the target and risk organs (OAR: organ at risk), optimization weight coefficients, and the like. In step S302, based on the synthetic CT image and contour data, the irradiation parameters are optimized to create the daily plan.

[0050] When step S302 is completed, step S303, step S304, steps S401 and S402 of the patient QA process P4, and step S501 of the irradiation process P5 are executed.

[0051] In step S303, based on the irradiation parameters of the original plan and the synthetic CT image, the dose distribution when irradiating according to the original treatment plan is calculated. In step S304, based on the irradiation parameters of the same-day plan and the synthetic CT image, the dose distribution of the same-day plan is calculated. In step S305, for the two dose distributions calculated in steps S303 and S304, based on the contour data of the original plan and the same-day plan, dose distribution indicators such as the DVH indicators, HI (Homogeneity Index), and CI (Conformity Index) of the target and OAR are calculated, and the achievement status of the clinical goal is displayed.

[0052] In step S306, the evaluation indicators calculated in step S305 are displayed, and the operator 70 is requested to select a treatment plan. The operator 70 checks the evaluation indicators and selects a treatment plan for the treatment on that day from the original plan and the same-day plan. If the original plan is selected, the calculations being performed in the patient QA process P4 are discarded, and step S501 of the irradiation process P5 is executed again. Further, the workflow manager 10 inputs information that the original plan has been selected to the software module that executes step S502. Furthermore, if the same-day plan is selected, the workflow manager 10 inputs information that the replanning process P3 has been completed to the software module that executes step S404. If it is determined that the same-day plan needs to be corrected, the process returns to step S301, and the replanning process P3 is executed again. Note that step S306 is not executed unless information indicating that the contour creation process P2 has been completed is input.

[0053] In the patient QA process P4, first, steps S401 and S402 are executed. In step S401, based on the synthetic CT image and the irradiation parameters of the same-day plan, the dose distribution of the same-day plan is calculated using a dose calculation algorithm different from that in step S303. In step S402, it is verified that the radiotherapy system 1 operates correctly during irradiation using the irradiation parameters of the same-day plan.

[0054] In step S403, based on the dose distribution calculated in step S401 and the contour data of the current plan, dose distribution indices such as the DVH indices, HI, and CI of the target and OAR are calculated, and the achievement status of the clinical goal is displayed. Also, the degree of agreement between the dose distributions calculated in steps S304 and S401 is evaluated by gamma analysis.

[0055] In step S404, the evaluation result calculated in step S403 and the verification result of S402 are displayed, and the operator 70 is requested to confirm the results. If the operator 70 approves, the workflow manager 10 inputs information indicating that the patient QA process P4 is completed to the software module that executes step S502. If the operator 70 does not approve, a choice between re-executing the treatment process or aborting the treatment is requested. If re-executing the treatment process is selected, a choice of the step to re-execute is requested. Note that step S404 is not executed unless information indicating that the replanning process P3 is completed is input.

[0056]

[0057]

[0058] In the irradiation process P5, first, the irradiation parameters are set in each control device in step S501. Next, if information indicating that the original plan is selected or information indicating that the patient QA process P4 is completed is input from the workflow manager 10, step S502 is executed. In step S502, the operator 70 is requested for permission to execute irradiation, and if permission is given, irradiation is started. If the treatment plan includes a plurality of irradiation fields, the position of the couch 50 and the angle of the rotating gantry 40 are sequentially corrected to execute irradiation. When irradiation is completed, in step S503, irradiation log data is generated. The irradiation log data includes data on the irradiation position and irradiation dose of the radiation. When step S503 is completed, steps S504 and S505 are executed. In step S504, based on the irradiation log data and the synthetic CT image, the actual dose distribution is calculated. Further, using the contour data of the current plan, the dose distribution indices of the actual dose distribution are calculated.

[0059] In step S505, based on the irradiation log data and the irradiation parameters of the daily plan, the operation of the radiation therapy system 1 during irradiation is verified. When steps S504 and S505 are completed, the treatment is completed.

[0060] Next, a method for creating a workflow will be described. Workflows are created for each treatment site and treatment protocol and registered in the workflow manager 10. The workflow used during treatment is selected from the workflows registered for each treatment plan.

[0061] FIG. 5 shows a screen display of the workflow manager 10 during treatment. For each step of the workflow, three states of completed, in execution, and not executed are displayed.

[0062] FIG. 6 shows a screen display of the workflow manager 10 when creating a workflow. The left region is for selecting registered modules. The upper central region is for constructing the workflow, and the progress of the steps in the process is constructed by connecting the modules. The lower central region is for displaying error messages and the like.

[0063] The right region is for setting each module, and for setting execution conditions, input and output contents, and execution contents. In the execution conditions, it is set whether the module is automatically executed or manually executed, in other words, whether it is a module that requires judgment and operation by the operator 70. For each registered module, input conditions necessary for executing the process and output contents output as a result of the process are set in advance. When the operator 70 connects a plurality of modules, the workflow manager 10 verifies the workflow based on whether the output conditions of the source module satisfy the input conditions of the destination module. If the output conditions of the source module satisfy the input conditions of the destination module, the workflow manager 10 makes a connection between the modules. On the other hand, if the output conditions of the source module do not satisfy the input conditions of the destination module, an error message is displayed.

[0064] The workflow is constructed by connecting registered modules. Also, a new workflow can be created by loading and modifying a registered workflow.

[0065] Next, the effects of this embodiment will be described.

[0066] In this embodiment, by executing in parallel a module that requests an operation from the operator 70 and a module of the next process, it is possible to shorten the treatment time.

[0067] Specifically, during the execution of step S106 of the positioning process P1, steps S201 - S207 of the contour creation process P2, S301 - S305 of the replanning process P3, steps S401 - S403 of the patient QA process P4, and S501 of the irradiation process P5 can be executed in parallel. Also, during the execution of step S208 of the contour creation process P2, S301 - S305 of the replanning process P3, steps S401 - S403 of the patient QA process P4, and S501 of the irradiation process P5 can be executed in parallel. Furthermore, during the execution of step S306 of the replanning process P3, steps S401 - S403 of the patient QA process P4, and S501 of the irradiation process P5 can be executed in parallel.

[0068] Thereby, in online adaptive radiotherapy where there are a large number of matters to be implemented on the same day, the required time for online adaptive treatment can be reduced.

[0069] Furthermore, in this embodiment, the steps executed within each process are managed as modules divided by element, and a workflow is constructed as the connection of modules. Thereby, it is possible to easily recognize modules that can be executed in parallel. Also, the connection between modules can be easily constructed and changed, and a flexible workflow can be constructed according to the preferences of the hospital and doctors. Furthermore, it is possible to construct a highly extensible workflow that can be updated in units of modules.

[0070] In addition, in this embodiment, by displaying the progress of the workflow using a workflow diagram expressed as the connection of modules, the completion status of the modules executed in parallel can be easily recognized.

[0071] Note that the present invention is not limited to the above-described embodiments, and includes various modifications. The above embodiments have been described in detail for easy understanding of the present invention, and are not necessarily limited to those having all the configurations described.

[0072] For example, the workflow shown in FIG. 4 is an example, and the steps managed as modules may be further subdivided, or a plurality of steps may be managed by one module. The steps shown in FIG. 4 can be omitted, and the execution order can also be changed.

[0073] In addition, the patient positioning system 11, the contour creation system 12, the replanning system 13, and the patient QA system 14 may be the same system, or may be some of the functions of the workflow manager 10.

[0074] In addition, each of the above-described configurations, functions, processing units, processing means, etc. may be realized in hardware by designing some or all of them, for example, by an integrated circuit. Further, each of the above-described configurations, functions, etc. may be realized in software by a processor interpreting and executing a program for realizing each function. Information such as programs, tables, and files for realizing each function can be stored in a memory, a recording device such as a hard disk or an SSD, or a recording medium such as an IC card, an SD card, or a DVD.

[0075] In addition, the control lines and information lines show those considered necessary for explanation, and not all control lines and information lines are necessarily shown on the product. In practice, it may be considered that almost all configurations are interconnected.

Description of Reference Numerals

[0076] 1: Radiation therapy system 10: Workflow manager 11: Patient positioning system 12: Contouring system 13: Re-planning system 14: Patient QA system 20: Imaging device 21: Imaging control device 30: Irradiation device 31: Irradiation control device 40: Rotating gantry 41: Gantry control device 50: Couch 51: Couch control device 60: Patient 61: Target 70: Operator

Claims

1. A workflow management system for executing a plurality of processes to be performed for carrying out radiation therapy according to a predetermined workflow, the plurality of processes includes at least a first process and a second process; the first process includes a calculation process and a judgment process for requesting an operator to make a judgment on a result of the calculation process; The workflow management system includes: a workflow management system that executes a calculation process of the second process based on a result of the calculation process of the first process while executing the judgment process.

2. The workflow management system includes:

2. The workflow management system according to claim 1, wherein the calculation process of the second process is executed during execution of the judgment process that requests the operator to make a judgment on an index of dose distribution that is a result of the calculation process.

3. The workflow management system according to claim 2 , further comprising a display unit for displaying the indicator of the dose distribution.

4. The workflow management system according to claim 1 , wherein the calculation process of the second process is a verification of device operation using irradiation parameters of a day's plan.

5. 2 . The workflow management system according to claim 1 , wherein the workflow management system judges whether or not to perform the calculation process again in the first process based on an input from the operator corresponding to the judgment.

6. The workflow management system according to claim 5 , wherein the workflow management system discards the calculation process of the second process when it determines that the calculation process is to be performed again.

7. The workflow management system includes: A plurality of information processing devices each executing the process including a different module; 2. The workflow management system according to claim 1, further comprising a management device that instructs said information processing device to execute a module in said process.

8. 8. The workflow management system according to claim 7, wherein the management device receives a calculation result from the process from the information processing device, and transmits the calculation result to the information processing device different from the information processing device that executed the process.

9. 8. The workflow management system according to claim 7, wherein the information processing device waits for execution of the module until an instruction to execute the module is received from the management device.

10. The workflow management system according to claim 7 , wherein the workflow management system creates the workflow by connecting a plurality of the modules.

11. The workflow management system according to claim 10 , wherein the workflow management system verifies the workflow based on an output condition of the source module and an input condition of the destination module.

12. The workflow management system includes: displaying the workflow by displaying the modules and their connections during execution of the workflow; The workflow management system according to claim 10 , further comprising: displaying a progress status of the workflow by displaying a progress status for each of the modules.

13. an imaging device for imaging a region of a patient including a target; a radiation irradiation device for irradiating the target with radiation; A workflow management system that executes a plurality of processes to be performed for carrying out radiation therapy according to a predetermined workflow; Equipped with the plurality of processes includes at least a first process and a second process; the first process includes a calculation process and a judgment process for requesting an operator to make a judgment on a result of the calculation process; The workflow management system includes: A radiation therapy system that executes a calculation process of the second process based on a result of the calculation process of the first process while executing the judgment process.

14. A workflow management method by a workflow management system that executes a plurality of processes to be executed for performing radiation therapy according to a predetermined workflow, comprising: the plurality of processes includes at least a first process and a second process; the first process includes a calculation process and a judgment process for requesting an operator to make a judgment on a result of the calculation process; The workflow management system includes: a workflow management method for executing a calculation process of the second process based on a result of the calculation process of the first process while the judgment process is being executed.

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