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

C. C. Dominguez; A. Torres; R. Alfonso

doi:10.15392/2319-0612.2024.2347

Autores/as

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

Palabras clave:

riesgo, braquiterapia ginecológica, FMEA, defensas, efectividad

Resumen

La implementación de un análisis de riesgos a todas aquellas prácticas que trabajan con radiaciones ionizantes es de primordial importancia. Gracias a los estudios publicados sobre evaluación de riesgos en medicina radiológica, se está creando una cultura sobre este tema, lo que ha propiciado la sistematización de diferentes métodos creados con este fin. Tal es el caso del Análisis de Modos de Fallo y Efectos (FMEA), base sobre la cual se ha desarrollado esta investigación. Se utiliza como principal referencia el informe de la Asociación Americana de Físicos Médicos (AAMP) TG-100, que proporciona todos los detalles sobre el uso de esta técnica. Por otro lado, también se utilizan las recomendaciones publicadas recientemente por el informe AAMP TG-275, el cual aplica la metodología FMEA a la braquiterapia ginecológica de alta tasa de dosis (B-HDR-GYN) y a otras prácticas médicas. La novedad de esta investigación es la implementación de un algoritmo operativo que mejora la capacidad analítica del enfoque FMEA tradicional al permitir medir la efectividad de las medidas de defensa dentro del mismo. En este estudio, cuando las medidas de defensa interactúan en el FMEA, ocurre una disminución de cuatro valores RPN de los modos de fallo (FM); en comparación con los valores de referencia. Este algoritmo se basa en una sinergia del enfoque de la matriz de riesgos (RM) y la información sobre el FMEA disponible en los TG-100 y TG-275.

Descargas

Los datos de descarga aún no están disponibles.

Referencias

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>.

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>.

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>.

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.

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/.

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.

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/.

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/.

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/.

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/.

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/.

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/.

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/.

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/.

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.

Torre, A. USERS MANUAL, SECURE-MR-FMEA, p.132, 2019.

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