Evaluation of the effectiveness of defense measures during radiological risk assessment in gynecological brachytherapy

Authors

  • C. C. Dominguez Department of Medical Physics, Nuclear Safety Directorate https://orcid.org/0000-0002-4658-975X
  • A. Torres High Institute of Applied Technologies and Sciences, University of Havana
  • R. Alfonso High Institute of Applied Technologies and Sciences, University of Havana

DOI:

https://doi.org/10.15392/2319-0612.2024.2347

Keywords:

risk, gynecologic brachytherapy, FMEA, defenses, Effectiveness

Abstract

The implementation of risk analysis to all those practices that work with ionizing radiation is of paramount importance. Thanks to the studies published on risk assessment in radiation medicine, a culture on this subject is being created, which has led to the systematization of different methods created for this purpose. Such is the case of the Failure Mode and Effects Analysis (FMEA), the basis on which this research has been developed. The American Association of Physicist in Medicine (AAMP) TG-100 report, which provides all the details on the use of this technique, is used as main reference. On the other hand, the recommendations recently published by AAMP TG-275 report are also used, applying the FMEA methodology to the high dose rate gynecological brachytherapy (B-HDR-GYN), among other practices. The novelty of this research is the implementation of an operational algorithm that improves the analytical capacity of the traditional FMEA approach by allowing the measurement of the effectiveness of defense measures within it. In this study, when the defense measures interact in the FMEA, a decrease of four RPN values of the failure modes (FM) occurs; compared to reference values. This algorithm is based on a synergy of the risk matrix (RM) approach and the information on FMEA available in the TG-100 and TG-275.

Downloads

Download data is not yet available.

References

Sung, H., Ferlay, J., Siegel, R. L., Laversanne, M., Soerjomataram, I., Jemal, A., & Bray, F.Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: A Cancer Journal for Clinicians, v.71, n .3, p .209–249, mayo/ junio 2021. Available at: <https://doi.org/10.3322/caac.21660>. DOI: https://doi.org/10.3322/caac.21660

Zubizarreta, E., Van Dyk, J., & Lievens, Y. Analysis of Global Radiotherapy Needs and Costs by Geographic Region and Income Level. Clinical Oncology, v. 29, p .84-92, 2017. Available at: <https://doi.org/10.1016/j.clon.2016.11.011>. DOI: https://doi.org/10.1016/j.clon.2016.11.011

Harding, K., & Thomson, W. H. Radiological protection and safety in medicine - ICRP 73. European Journal of Nuclear Medicine, v. 24, n .10, 1997.

International Atomic Energy Agency (IAEA). Generic procedures for assessment and response during a radiological emergency. Dose Assesment, Iaea-Tecdoc-11162, p .81–122, August 2000. Available at: <http://www-pub.iaea.org/mtcd/publications/pdf/te_1162_prn.pdf>.

International Atomic Energy Agency (IAEA). Application of the Risk Matrix Method to Radiotherapy. IAEA TECDOC-1685, 2016.

Huq, M. S., Fraass, B. A., Dunscombe, P. B., Gibbons, J. P., Ibbott, G. S., Mundt, A. J., Mutic, S., Palta, J. R., Rath, F., Thomadsen, B. R., Williamson, J. F., & Yorke, E. D. (2016). The report of Task Group 100 of the AAPM: Application of risk analysis methods to radiation therapy quality management. Medical Physics, v. 43, n .7, p.4209–4262. Available at: <https://doi.org/10.1118/ 1.4947547>. DOI: https://doi.org/10.1118/1.4947547

Ford, E., Conroy, L., Dong, L., de Los Santos, L. F., Greener, A., Gwe-Ya Kim, G., Johnson, J., Johnson, P., Mechalakos, J. G., Napolitano, B., Parker, S., Schofield, D., Smith, K., Yorke, E., & Wells, M. Strategies for effective physics plan and chart review in radiation therapy: Report of AAPM Task Group 275. Medical Physics, v.47, n.6, p. e236–e272, 2020. Available at: https://doi.org/10.1002/mp.14030. DOI: https://doi.org/10.1002/mp.14030

Teixeira, F.C., de Almeida, C.E., Hug, S. Failure mode and effects analysis-based risk profile assessment for stereotactic radiosurgery programs at three cancer centers in Brazil. Medical physics, v.43, n .1, p.171-178, 2016.

Tonigan, J., Balter, P.A., Johnson, J.L., Kry, S., Court, L.E. et al. An FMEA evaluation of intensity modulated radiation therapy dose delivery failures at tolerance criteria levels. Medical physics, v.44, n .11, 2017. Available at: https://pubmed.ncbi.nlm.nih.gov/28862765/. DOI: https://doi.org/10.1002/mp.12551

Veronese, I., De Martin, E., Martinotti, A.S., Fumagalli, M.L., Vite, C., Redaelli, I., Malatesta, T., et al. Multi-institutional application of Failure Mode and Effects Analysis (FMEA) to CyberKnife Stereotactic Body Radiation Therapy (SBRT). Radiation Oncology, v.10, n .132, 2015. Available at: https://ro-journal.biomedcentral.com/articles/10.1186/s13014-015-0438-0. DOI: https://doi.org/10.1186/s13014-015-0438-0

Vidali, C., Severgnini, M., Urbani, M., Toscano, L., Perulli, A., Bortul, M. et al. FMECA application to intraoperative electron Beam Radiotherapy Procedure as a Quality method to Prevent and Reduce Patient’s Risk in Conservative surgery for Breast Cancer. Frontier in medicine, v.4, n.138, 2017. Available at: https://pubmed.ncbi.nlm.nih.gov/28894737/. DOI: https://doi.org/10.3389/fmed.2017.00138

Perks, J.R., Stanic, S., Stern, R.L., Henk, B. et al. Failure Mode and Effect Analysis for Delivery of Lung Stereotactic Body Radiation Therapy. International Journal of Radiation Oncology-Biology-Physics, v.83, n.4, p .1324-1329, 2012. Available at: https://pubmed.ncbi.nlm.nih.gov/22197236/. DOI: https://doi.org/10.1016/j.ijrobp.2011.09.019

Broggi, S., Cantone, M.C., Chiara, A., Di Muzio, N. et al. Application of failure mode and effects analysis (FMEA) to pretreatment phases in tomotherapy. Journal of Applied Clinical Medical physics, v.15, n.5, 2013. Available at: https://pubmed.ncbi.nlm.nih.gov/24036868/. DOI: https://doi.org/10.1120/jacmp.v14i5.4329

Wexler, A., Gu, B., Goddu, S., Mutic, M. et al. FMEA of manual and automated methods for commissioning a radiotherapy treatment planning system. Medical Physics, v.44, n.9, 2017. Available at: https://pubmed.ncbi.nlm.nih.gov/28419482/. DOI: https://doi.org/10.1002/mp.12278

Yuanguang, X.A., Bhatnagar, J., Bednarz, G., Flickinger, J. et al. Failure modes and effects analysis (FMEA) for Gamma Knife radiosurgery. Journal of Applied Clinical Medical Physics, v.18, n.6, p.152-168 2017. Available at: https://pubmed.ncbi.nlm.nih.gov/29082599/. DOI: https://doi.org/10.1002/acm2.12205

Sawant, A., Dieterich, S. Failure mode and effect analysis-based quality assurance for dynamic MLC tracking systems. Medical Physics, v.37, n.12, 2010. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3016096/. DOI: https://doi.org/10.1118/1.3517837

Manger, R.P., Paxton, A.B.., Pawlicki, T., Kim, G. Failure mode and effects analysis and fault tree analysis of surface image guided cranial radiosurgery. Medical Physics, v.42, n.5, 2015. Available at: https://pubmed.ncbi.nlm.nih.gov/25979038/. DOI: https://doi.org/10.1118/1.4918319

Schuller, B.W., Burns, A., Ceilley, E.A., King, A., et al. Failure mode and effects analysis: A community practice perspective, Journal of Applied Clinical Medical Physics, v.18, n.6, p.258-267, 2017. Available at: https://pubmed.ncbi.nlm.nih.gov/28944980/. DOI: https://doi.org/10.1002/acm2.12190

Torre, A., Amador Z., Alfonso, R., Lauren, L., & Hardy, E. SECURE-MR-FMEA código cubano para análisis integral de riesgo de prácticas con radiaciones ionizantes. Nucleus, p.44–55, 2021.

Torres A., Amador Z., Alfonso R., et al. Risk management in medical practices with ionizing radiation, An Acad Cienc Cuba. v.13, n.6, 2023. ISSN 2304-0106 | RNPS 2308 (in Spanish).

Torres A., Alfonso R., Amador Z., SECURE-MR-FMEA: A tool for automating the AAPM TG-275 approach in the physics chart and plan review during EBRT, XXVI Congresso Brasileiro de Física Médica, IX Congresso Latino Americano de Física Médica, Fortaleza – Brasil, June 07 to 11, 2022

Teixeira FC, de Almeida CE, Saiful Huq M. Failure mode and effects analysis based risk profile assessment for stereotactic radiosurgery programs at three cancer centers in Brazil. Med Phys, v.43, n.1, 2016. DOI: https://doi.org/10.1118/1.4938065

Torre, A. USERS MANUAL, SECURE-MR-FMEA, p.132, 2019. DOI: https://doi.org/10.3917/ecofi.132.0009

International Atomic Energy Agency (IAEA). Application of the Risk Matrix Method to Radiotherapy. IAEA TECDOC-1685, v.88, 2016.

Downloads

Published

2024-02-16

Issue

Section

Articles

How to Cite

Evaluation of the effectiveness of defense measures during radiological risk assessment in gynecological brachytherapy. Brazilian Journal of Radiation Sciences, Rio de Janeiro, Brazil, v. 12, n. 1, p. e2347, 2024. DOI: 10.15392/2319-0612.2024.2347. Disponível em: https://bjrs.org.br/revista/index.php/REVISTA/article/view/2347.. Acesso em: 5 nov. 2024.

Similar Articles

1-10 of 144

You may also start an advanced similarity search for this article.