A risk-based approach to development of ultrasound-based high-dose-rate prostate brachytherapy quality management

Poder, Joel; Brown, Ryan; Howie, Andrew; Yuen, Johnson; Ralston, Anna; Schreiber, Kristine; Bece, Andrej; Bucci, Joseph

doi:10.1016/j.brachy.2018.05.005

Cited by 18 publications

(17 citation statements)

References 25 publications

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“…To manually simulate source positioning errors in the 16 HDR prostate BT treatment plans used in this study, a script was developed in Python to edit the 3D coordinates of the dwell positions in the treatment plans. As identified in a previous study, the two distinct types of treatment source positioning errors were considered in this study 14 …”

Section: Methodsmentioning

confidence: 99%

“…The first type of source positioning error results in delivered dwell positions of all catheters in the plan being shifted in the cranial/caudal direction relative to their planned positions. Examples of these types of errors include incorrect catheter index length used in BTPS, BTPS coordinate system origin not set correctly, and incorrect catheter free length used in BTPS 14 . In this study, these source positioning errors were simulated by shifting dwell positions in all catheters from ‐6 mm (caudal) to +6 mm (cranial) in 1 mm increments.…”

Section: Methodsmentioning

confidence: 99%

“…As identified in a previous study, the two distinct types of treatment source positioning errors were considered in this study. 14 The first type of source positioning error results in delivered dwell positions of all catheters in the plan being shifted in the cranial/caudal direction relative to their planned positions. Examples of these types of errors include incorrect catheter index length used in BTPS, BTPS coordinate system origin not set correctly, and incorrect catheter free length used in BTPS.…”

Section: Simulated Treatment Planning Source Positioning Errorsmentioning

confidence: 99%

“…Examples of these types of errors include incorrect catheter index length used in BTPS, BTPS coordinate system origin not set correctly, and incorrect catheter free length used in BTPS. 14 In this study, these source positioning errors were simulated by shifting dwell positions in all catheters from -6 mm (caudal) to +6 mm (cranial) in 1 mm increments.…”

Section: Simulated Treatment Planning Source Positioning Errorsmentioning

confidence: 99%

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HDR prostate brachytherapy plan robustness and its effect on in‐vivo source tracking error thresholds: A multi‐institutional study

et al. 2022

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The purpose of this study was to examine the effect of departmental planning techniques on appropriate in-vivo source tracking error thresholds for high dose rate (HDR) prostate brachytherapy (BT) treatments, and to determine if a single in-vivo source tracking error threshold would be appropriate for the same patient anatomy. Methods: The prostate, rectum, and urethra were contoured on a single patient transrectal ultrasound (TRUS) dataset. Anonymized DICOM files were disseminated to 16 departments who created an HDR prostate BT treatment plan on the dataset with a prescription dose of 15 Gy in a single fraction. Departments were asked to follow their own local treatment planning guidelines. Source positioning errors were then simulated in the 16 treatment plans and the effect on dose-volume histogram (DVH) indices calculated. Change in DVH indices were used to determine appropriate in-vivo source tracking error thresholds. Plans were considered to require intervention if the following DVH conditions occurred: prostate V100% < 90%, urethra D0.1cc > 118%, and rectum tt Dmax > 80%. Results: There was wide variation in appropriate in-vivo source tracking error thresholds among the 16 participating departments, ranging from 1 to 6 mm. Appropriate in-vivo source tracking error thresholds were also found to depend on the direction of the source positioning error and the endpoint. A robustness parameter was derived, and found to correlate with the sensitivity of plans to source positioning errors. Conclusions: A single HDR prostate BT in-vivo source tracking error threshold cannot be applied across multiple departments, even for the same patient anatomy. The burden on in-vivo source tracking devices may be eased through improving HDR prostate BT plan robustness during the plan optimisation phase.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Simulated Treatment Planning Source Positioning Errorsmentioning

confidence: 99%

Section: Simulated Treatment Planning Source Positioning Errorsmentioning

confidence: 99%

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HDR prostate brachytherapy plan robustness and its effect on in‐vivo source tracking error thresholds: A multi‐institutional study

et al. 2022

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“…In this study, we apply the American Association of Physicists in Medicine (AAPM) Task Group 100 (TG-100) Failure Modes and Effects Analysis (FMEA) methodology 22 to apply modern risk-based analysis techniques to IGCSAI, as it has been done for a number of other medical physics applications. [22][23][24][25][26][27][28][29][30][31][32][33][34][35] In the process, we propose a new process map specific to IGCSAI that changes the paradigm from individual errors in radiation delivery, to groups that are highlighted in a proposed new severity table. We also perform a preliminary FMEA survey based on expert opinion from SARRP operators.…”

Section: Introductionmentioning

confidence: 99%

A failure modes and effects analysis quality management framework for image‐guided small animal irradiators: A change in paradigm for radiation biology

et al. 2020

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Purpose: Image-guided small animal irradiators (IGSAI) are increasingly being adopted in radiation biology research. These animal irradiators, designed to deliver radiation with submillimeter accuracy, exhibit complexity similar to that of clinical radiation delivery systems, including image guidance, robotic stage motion, and treatment planning systems. However, physics expertise and resources are scarcer in radiation biology, which makes implementation of conventional prescriptive QA infeasible. In this study, we apply the failure modes and effect analysis (FMEA) popularized by the AAPM task group 100 (TG-100) report to IGSAI and radiation biological research. Methods: Radiation biological research requires a change in paradigm where small errors to large populations of animals are more severe than grievous errors that only affect individuals. To this end, we created a new adverse effects severity table adapted to radiation biology research based on the original AAPM TG-100 severity table. We also produced a process tree which outlines the main components of radiation biology studies performed on an IGSAI, adapted from the original clinical IMRT process tree from TG-100.Using this process tree, we created and distributed a preliminary survey to eight expert IGSAI operators in four institutions. Operators rated proposed failure modes for occurrence, severity, and lack of detectability, and were invited to share their own experienced failure modes. Risk probability numbers (RPN) were calculated and used to identify the failure modes which most urgently require intervention. Results: Surveyed operators indicated a number of high (RPN >125) failure modes specific to small animal irradiators. Errors due to equipment breakdown, such as loss of anesthesia or thermal control, received relatively low RPN (12-48) while errors related to the delivery of radiation dose received relatively high . Errors identified could either be improved by manufacturer intervention (e.g., electronic interlocks for filter/collimator) or physics oversight (errors related to tube calibration or treatment planning system commissioning). Operators identified a number of failure modes including collision between the collimator and the stage, misalignment between imaging and treatment isocenter, inaccurate robotic stage homing/translation, and incorrect SSD applied to hand calculations. These were all relatively highly rated , indicating a possible bias in operators towards reporting high RPN failure modes. Conclusions: The first FMEA specific to radiation biology research was applied to image-guided small animal irradiators following the TG-100 methodology. A new adverse effects severity table and a process tree recognizing the need for a new paradigm were produced, which will be of great use to future investigators wishing to pursue FMEA in radiation biology research. Future work will focus on expanding scope of user surveys to users of all commercial IGSAI and collaborating with manufacturers to increase the breadth of surveyed expert operato...

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AAPM task group report 303 endorsed by the ABS: MRI implementation in HDR brachytherapy—Considerations from simulation to treatment

et al. 2022

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The task group (TG) on magnetic resonance imaging (MRI) implementation in high-dose-rate (HDR) brachytherapy (BT)-Considerations from simulation to treatment, TG 303, was constituted by the American Association of Physicists in Medicine's (AAPM's) Science Council under the direction of the Therapy Physics Committee, the Brachytherapy Subcommittee, and the Working Group on Brachytherapy Clinical Applications. The TG was charged with developing

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A risk-based approach to development of ultrasound-based high-dose-rate prostate brachytherapy quality management

Cited by 18 publications

References 25 publications

HDR prostate brachytherapy plan robustness and its effect on in‐vivo source tracking error thresholds: A multi‐institutional study

HDR prostate brachytherapy plan robustness and its effect on in‐vivo source tracking error thresholds: A multi‐institutional study

A failure modes and effects analysis quality management framework for image‐guided small animal irradiators: A change in paradigm for radiation biology

AAPM task group report 303 endorsed by the ABS: MRI implementation in HDR brachytherapy—Considerations from simulation to treatment

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