Founded in 1974, San Antonio, Texas-based Cancer Therapy and Research Center (CTRC) is a world leader in cancer treatment and research. Since its founding, the not-for-profit center has handled nearly 1 million patient visits, and in 2002, more than 120,000 visits. The CTRC is also actively involved in the discovery of the causes, prevention and cure of cancer, and is active in the promotion of cancer education and prevention practices.
The CTRC has seen a recent increase in the number of patients needing radiation oncology treatment, which has had a large impact on its computer storage strategy. This is because the CTRC's radiation oncology department relies on data-intensive diagnostics such as magnetic resonance imaging (MRI), CT and positron emission tomography (PET) scans for treatment that the CTRC stores in electronic format online.
The CTRC maintains eight radiation treatment vaults that provide radiation therapy for an average of 200 patients a day on four-week cycles. For each patient, the CTRC estimates that the radiation oncology department builds about a 100-MB treatment plan based on the MRI, CT and PET scans stored on the servers. Also stored on the servers is information on radiation treatments, treatment scheduling, medical transcripts, patient demographics and billing records Defining Storage Needs
In short, CTRC tripled its storage requirements from 1 TB to 3 TB. One terabyte is roughly equivalent to the aggregate storage capacity in 50 laptop computers, each with 20-GB disk drives. Two years ago, CTRC analyzed the cost and growth of its existing server-attached storage architecture and realized that it was difficult and costly to scale and also did not provide the level of availability that was necessary to its critical operations.
The CTRC can treat a patient every 10 minutes in each of its radiation vaults. To provide treatment, radiation oncology uses a number of online applications that automatically record and track chemotherapy radiation doses administered in the radiation vaults. This information provides a precise history of the dosage received by each patient, ensuring a correct treatment each visit. But if the server fails, the application goes offline and the CTRC loses the invaluable aid of the application to accurately track radiation therapy treatments.
"We are very dependent on the online servers," says Mike Luter, chief technology officer at the CTRC. "If a server is down, it can cause delayed or sometimes missed treatments altogether, and this can be very dangerous to our patients. Each vault is a $1.7 million capital asset that we can't afford to have sitting idle."
The Storage Challenge
CTRC installed a storage area network (SAN) and an EMC F4700 storage array at each of its key locations--its medical facility and main research facility--22 miles apart. While this provided each facility with centralized storage, the CTRC also wanted two other capabilities: the ability for the servers in each facility to be able to access resources in the other, and the ability to mirror the SANs so that the research facility could act as a backup to the primary site. This would allow efficient use of the existing storage and servers, avoiding the need to purchase additional servers and storage for dedicated backup.
The challenge was that 22 miles separated the medical center from the research facility. However, the CTRC learned that Fibre Channel, the most popular transport technology for interconnecting SAN devices, has a practical limit of 10 kilometers, with the option to use extenders to go beyond 10 kilometers being prohibitively expensive.
CTRC's solution was closer than first realized. It was already leasing a Gigabit IP Ethernet connection from a local supplier that provided it with pure Gigabit Ethernet across the 22 miles, and it had bandwidth to spare on the connection. To take advantage of this readily available transport, the CTRC chose iSCSI technology available through the Cisco SN 5428 Storage Router.
The Cisco SN 5428 is a multiprotocol platform that offered both the flexibility of low-cost storage connectivity using iSCSI technology and Fibre Channel connectivity for high-end or high-volume applications that require the absolute highest performance. To ensure highest availability, the CTRC installed redundant pairs of the routers at both the main site and the backup site.
To use iSCSI, the CTRC downloaded the iSCSI drivers from the Cisco Web site and installed them on various servers. The iSCSI drivers encapsulate the SCSI commands within IP packets, which are then sent onto the IP network and switched to the Gigabit Ethernet ports on the Cisco SN 5428 Storage Router. From here, traffic is transmitted out the Cisco SN 5428's Fibre Channel ports directly to the EMC F4700. Using iSCSI, CTRC was able to avoid installing costly Fibre Channel host bus adapters that are required when servers connect directly to SANs over Fibre Channel. Instead, it could use lower-cost Ethernet network interface cards.
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