{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T11:33:25Z","timestamp":1787657605915,"version":"build-2736575974"},"reference-count":21,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:00:00Z","timestamp":1761091200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["1R18HS030060"],"award-info":[{"award-number":["1R18HS030060"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["5T32EB002101\u201047"],"award-info":[{"award-number":["5T32EB002101\u201047"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Radiation Oncology departments impacted by recent cyberattacks were unable to access data backups or their Record and Verify (R&amp;V) system and therefore faced challenges to resume patient treatments in a timely manner. We present a novel software tool that backs\u2010up critical radiotherapy treatment information and displays essential information for on\u2010treatment patients in an intuitive and accessible dashboard allowing clinics to continue radiotherapy treatments. The purpose of this report is to describe implementation details, challenges, and share open\u2010source code to facilitate radiation oncology clinics\u2019 efforts to develop tools to improve cyberattack resiliency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The Radiotherapy Backup and Recovery Dashboard Tool (RBRDT) performs daily backups of treatment information and relationships between DICOM\u2010RT objects from the R&amp;V system and treatment planning system (TPS) to a Radiation Therapy Picture Archiving and Communication System (RT\u2010PACS). If the R&amp;V system is inaccessible, the RBRDT accesses the backed\u2010up data in the RT\u2010PACS to create a dashboard containing critical treatment information for patients currently undergoing radiotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The RBRDT is successfully clinically implemented and generates backups to the RT\u2010PACS every 10 minutes. Since its implementation in May 2024, the RBRDT backed up over 80,000 RTRECORDS and moved 322 RTPLANS and 142 RTSTRUCTS to the RT\u2010PACS that were absent from this server caused by human error. The dashboard is generated nightly.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The RBRDT fills a critical gap in existing approaches for radiotherapy treatment data backup and restoration. All relational data is transferred to the RT\u2010PACS which is accessible during a cyberattack, reducing the reliance on the R&amp;V system. The RBRDT retrieves connected data elements saved in separate locations. In the event of a cyberattack, this data is returned in a dashboard to rapidly resume patient treatments.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acm2.70292","type":"journal-article","created":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T03:25:57Z","timestamp":1761189957000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Enhancing cyberattack resiliency through the radiotherapy backup and recovery dashboard tool"],"prefix":"10.1002","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-4420-0885","authenticated-orcid":false,"given":"Justin","family":"Pijanowski","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology University of California Los Angeles  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0836-2844","authenticated-orcid":false,"given":"Eric","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of California Los Angeles  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasin","family":"Abdulkadir","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of California Los Angeles  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Hink","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of California Los Angeles  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yevgeniy","family":"Vinogradskiy","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Thomas Jefferson University Hospital  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Lamb","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of California Los Angeles  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,22]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1200\/OP.21.00116"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.adro.2020.11.001"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.adro.2021.100796"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.adro.2022.100896"},{"key":"e_1_2_9_6_1","article-title":"The impact of a ransomware cyber attack on a breast cancer center","author":"Harvey H","year":"2022","journal-title":"Am Soc Clin Oncol"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.37549\/ARO1176"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.adro.2022.100914"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prro.2021.09.011"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.30972"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0167\u20108140(98)00038\u20103"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rpor.2015.05.010"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m4087"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2016.08.027"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2009.11.029"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.3109\/02841868809090333"},{"issue":"9","key":"e_1_2_9_17_1","article-title":"The relationship between tumor volume and timing of post\u2010resection stereotactic radiosurgery to maximize local control: a critical review","volume":"11","author":"Yuan M","year":"2019","journal-title":"Cureus"},{"key":"e_1_2_9_18_1","unstructured":"NEMA PS3 \/ISO 12052.Digital Imaging and Communications in Medicine (DICOM) Standard."},{"key":"e_1_2_9_19_1","unstructured":"MasonDL et al.pydicom: An open source DICOM library. GitHub. Accessed April 1 2024.https:\/\/github.com\/pydicom\/pydicom"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.12886"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.adro.2022.100897"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10278\u2010018\u20100082\u2010y"}],"container-title":["Journal of Applied Clinical Medical Physics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acm2.70292","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,15]],"date-time":"2025-11-15T11:45:36Z","timestamp":1763207136000},"score":1,"resource":{"primary":{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/10.1002\/acm2.70292"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,22]]},"references-count":21,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1002\/acm2.70292"],"URL":"https:\/\/doi.org\/10.1002\/acm2.70292","archive":["Portico"],"relation":{},"ISSN":["1526-9914","1526-9914"],"issn-type":[{"value":"1526-9914","type":"print"},{"value":"1526-9914","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,22]]},"assertion":[{"value":"2025-04-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70292"}}