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Purpose: i) To show the feasibility of using CT scout images for 2D low‐dose rate brachytherapy planning with BrachyVision (version 10.4); ii) to show their advantages and disadvantages over DRRs. Methods: A phantom was constructed to house a Fletcher‐Suite applicator. The phantom is made of Styrofoam with metal BBs positioned at well‐defined separations. These markers are used to assess the image distortion in the scout images. Unlike DRRs, scout images are distorted only in the direction normal to the couch direction; therefore, they needed to be scaled unidirectionally prior to importing into BrachyVision. In addition to confirming the scaling is performed correctly by measuring distances between well‐positioned BB, we also compare a LDR plan using scout images to a 3D CT‐based plan. Results: There is no distortion of the image along the couch direction due to the collimation of the CT scanner. The distortion in the transverse plane can be corrected by multiplying by the ratio of distances between source‐to‐isocenter and source‐to‐detector. The results show the distance separations between BBs as measured in scout images and by a caliber are within a few millimeters. Dosimetrically, the difference between the dose rates to points A and B based on scout images and on 3D CT are less than a few percents. The accuracy can be improved by correcting for the distortion on the transverse plane. Conclusion: It is possible to use CT scout images for 2D planning in BrachyVision. This is an advantage because scout images have no metal artifacts often present in CT images or DRRs. Another advantage is the lack of distortion in the couch direction. One major disadvantage is that the image distortion due to beam divergence can be large. This is due to the inherent short distance between source‐to‐isocenter and source‐to‐detector on a CT scanner.

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the need for process evaluation in the context of high profile accidents. A multidisciplinary team was assembled with representation from each major discipline. Stereotactic radiosurgery (SRS) was identified as an ideal treatment technique for the first FMEA evaluation, as it is a largely selfcontained process in our department and has the potential to produce high impact failure modes. Process mapping was completed using breakout sessions, and then compiled into a simple electronic format. Weekly sessions were used to complete the FMEA evaluation. Risk priority number (RPN) values > 100 or severity scores of 9 or 10 were considered high risk. The overall time commitment was also tracked. Results: We found that FMEA was feasible, though time-intensive, within our small community practice. The estimated person-hour equivalent for project completion was 258 hours. Key steps included: clear definition of project scope, motivated team recruitment, coordinated completion of FMEA task assignments, determination of appropriate process map detail level, and ensuring FMEA scoring consistency. Splitting the process map into individual assignments was a successful strategy for our group. The process map was designed to contain enough detail such that another radiation oncology team would be able to perform our procedures. The FMEA evaluation utilized weekly open sessions to provide facilitator support and optimize team member input. Continuous facilitator involvement helped maintain consistent scoring. The final SRS process map contained 15 major process steps and 183 sub-process steps. Conclusion: This study provides important details on the steps we took to complete our first FMEA, providing guidance for community practices seeking to incorporate this process into their quality assurance (QA) program. Based on our data and experiences, we estimate that 6-12 months will be required for a clinic to complete their first FMEA, with subsequent analyses likely progressing more quickly once a group has developed familiarity with the technique. Determining the feasibility of implementing complex QA processes into different practice settings will take on increasing significance as the field transitions into the new AAPM TG-100 QA paradigm.