Comparison of failure modes and effects analyses and time for brachytherapy ring and tandem applicator digitization between manual and solid applicator source placement methods
Purpose Ring and tandem (R&T) applicator digitization is currently performed at our institution by manually defining the extent of the applicators. Digitization can also be achieved using solid applicators: predefined, 3D models with geometric constraints. This study compares R&T digitizatio...
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Published in | Journal of applied clinical medical physics Vol. 25; no. 5; pp. e14336 - n/a |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
John Wiley & Sons, Inc
01.05.2024
John Wiley and Sons Inc |
Subjects | |
Online Access | Get full text |
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Summary: | Purpose
Ring and tandem (R&T) applicator digitization is currently performed at our institution by manually defining the extent of the applicators. Digitization can also be achieved using solid applicators: predefined, 3D models with geometric constraints. This study compares R&T digitization using manual and solid applicator methods through Failure Modes and Effects Analyses (FMEAs) and comparative time studies. We aim to assess the suitability of solid applicator method implementation for R&T cases
Methods
Six qualified medical physicists (QMPs) and two medical physics residents scored potential modes of failure of manual digitization in an FMEA as recommended by TG‐100. Occurrence, severity, and detectability (OSD) values were averaged across respondents and then multiplied to form combined Risk Priority Numbers (RPNs) for analysis. Participants were trained to perform treatment planning using a developed solid applicator protocol and asked to score a second FMEA on the distinct process steps from the manual method. For both methods, participant digitization was timed. FMEA and time data were analyzed across methods and participant samples
Results
QMPs rated the RPNs of the current, manual method of digitization statistically lower than residents did. When comparing the unique FMEA steps between the two digitization methods, QMP respondents found no significant difference in RPN means. Residents, however, rated the solid applicator method as higher risk. Further, after the solid applicator method was performed twice by participants, the time to digitize plans was not significantly different from manual digitization
Conclusions
This study indicates the non‐inferiority of the solid applicator method to manual digitization in terms of risk, according to QMPs, and time, across all participants. Differences were found in FMEA evaluation and solid applicator technique adoption based on years of brachytherapy experience. Further practice with the solid applicator protocol is recommended because familiarity is expected to lower FMEA occurrence ratings and further reduce digitization times. |
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Bibliography: | TH‐ Brachytherapy: GYN intracavity brachytherapy, TH‐ Brachytherapy: Virtual planning comparisons, IM/TH‐ Formal quality management tools: Failure modes and effects analysis ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 |
ISSN: | 1526-9914 1526-9914 |
DOI: | 10.1002/acm2.14336 |