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Radiotherapy planning software that isn't tied to the vendor's machine

editorial

Software & Systems · early attempts · hardest part: regulatory, engineering, capital

A treatment planning system is a large per-site licence bound to one manufacturer's linear accelerator, and the dose physics underneath it is textbook material.

This is editorial, not a record. Registry entries are cited facts about things that exist; an opportunity is our argument about something that does not. The links to existing work are checked against the catalog — the judgment around them is ours, and you should disagree with it where you know better.

why it stays closed

Treatment planning is sold with the accelerator, and the commercial planning system is a substantial recurring cost and a lock-in point: planning, delivery, and quality assurance are integrated by design. The dose calculation physics — Monte Carlo transport, pencil beam models — is published and taught. The moat is clinical validation, certification, and integration with a specific machine's control system.

what is missing

Not the dose engine; credible open engines exist in the research world. What is missing is everything that makes one usable clinically: commissioning against a real accelerator, an auditable quality assurance workflow, DICOM-RT interoperability that survives contact with vendor implementations, and a regulatory route for planning software that determines a delivered dose.

who this is for

Cancer centres where the planning licence is a material share of the budget, and the many regions with accelerators but insufficient physics support.

what already exists · 3
  • 3D SlicerverifiedLicenseRef-Slicer-1.0

    Desktop platform for medical image visualisation, segmentation, registration, and image-guided therapy research.

  • dcm4cheverifiedMPL-1.1

    Collection of DICOM implementations and clinical imaging archive tooling used in production PACS deployments.

  • OHIF ViewerverifiedMIT

    Zero-footprint web-based DICOM viewer for radiology and clinical research workflows.

sources

None cited. Everything above is either reasoning about market structure or a claim you should check yourself. Where we could not source a number, we left it out rather than estimating one.

Last revised 2026-08-05.