Analysis of Medical Events in High-Dose-Rate Brachytherapy

Gao, Wanbao

doi:10.1016/j.brachy.2013.01.122

Cited by 1 publication

(2 citation statements)

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“…The Information Notice 2013–2016 issued by the Nuclear Regulatory Commission (NRC) in 2013 emphasized the need for verification of treatment parameters prior to HDR treatment 1 . Incorrect manual entry into the treatment planning system (TPS) of the treatment distance was found to be a major source of HDR treatment errors reported to the NRC and International Atomic Energy Agency between 1980 and 2001 2 . More recent analysis of HDR treatment errors reported to the NRC between 1999 and 2015 found that ~63% were due to either mislabeling of catheters or the specification of the wrong treatment length in the TPS, resulting in treatment targets being missed by 0.4–30 cm 2–4 …”

Section: Introductionmentioning

confidence: 99%

“…2 More recent analysis of HDR treatment errors reported to the NRC between 1999 and 2015 found that~63% were due to either mislabeling of catheters or the specification of the wrong treatment length in the TPS, resulting in treatment targets being missed by 0.4-30 cm. [2][3][4] Surface applicators are customized to the shape and size of the lesion. Custom-made applicators have variability in treatment length of catheters.…”

Section: Introductionmentioning

confidence: 99%

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Technical Note: Scintillation markers for real‐time visual source tracking during skin high dose rate brachytherapy

Huynh

Bhagwat

2020

Medical Physics

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Background Treatment misadministration during high dose rate (HDR) brachytherapy is mainly caused due to gross errors in incorrect manual entry of catheter length and manual connection of hardware. The probability of these errors increases with increasing complexity of a surface applicator. A simple, real‐time visual verification method was developed using a scintillator to enhance quality assurance (QA) measures for HDR surface brachytherapy and thus reduce manual errors and improve patient safety. Materials and methods Scintillation markers were fabricated from cerium‐doped lutetium yttrium orthosilicate (LYSO) embedded in a polymer compound to form 5‐mm diameter markers. To verify catheter‐transfer tube connections, markers were attached to each channel of a Freiburg flap and irradiated with an 192Ir source. To determine if the source reached the edge of a target, markers were placed along the periphery. The HDR source was visually tracked by following the illumination from the markers. The response of the markers was also verified in the presence of thermoplastic material overlaid on the Freiburg applicator. Results Scintillation markers emitted intense blue visible light upon irradiation when the HDR source was beneath the marker, verifying the source’s presence in the correct catheter. The signal was clearly visible even when the marker was placed on top of the thermoplastic material covering the Freiburg Flap. Crosstalk from adjacent catheters was <50% of the maximum light intensity. Conclusion Scintillation markers and paint were developed to successfully meet the challenge of visually tracking of HDR source during brachytherapy by surface applicators. This direct visualization of source allows real‐time catheter verification during treatment, and correct superficial target coverage, thus preventing a medical event. It can easily be integrated into pre‐existing QA program.

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Section: Introductionmentioning

confidence: 99%