6
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Nuevo algoritmo para análisis de riesgo en radioterapia Translated title: New algorithm for risk analysis in radiotherapy

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Los análisis de riesgo aplicados a los tratamientos de radioterapia se han convertido en una necesidad innegable, partiendo de los peligros generados por la combinación del empleo de potentes campos de radiación sobre los pacientes y la ocurrencia de errores humanos y fallos de equipos durante esos tratamientos. La técnica por excelencia para llevar a cabo estos análisis ha sido la matriz de riesgo. El trabajo presenta el desarrollo de un nuevo algoritmo para ejecutar esta tarea con amplias potencialidades gráficas y analíticas, lo que lo convierte en una opción muy útil para el monitoreo del riesgo y la optimización de los programas de garantía de calidad. El sistema SECURE-MR, soporte informático de este algoritmo, se empleó con éxito en el análisis de riesgo de diversas prácticas de radioterapia. Lo distinguen nuevas posibilidades de análisis partiendo de la consideración de factores controladores del riesgo como las robusteces de frecuencia de iniciadores y de consecuencias. Sus capacidades analíticas y gráficas permiten novedosos desarrollos de ordenamiento de contribuyentes al riesgo y de representación de la información de procesos y secuencias accidentales. El trabajo muestra la aplicación del sistema propuesto a un proceso genérico de tratamiento de radioterapia con acelerador lineal

          Translated abstract

          Risk analyses applied to radiotherapy treatments have become an undeniable necessity, considering the dangers generated by the combination of using powerful radiation fields on patients and the occurrence of human errors and equipment failures during these treatments. The technique par excellence to execute these analyses has been the risk matrix. This paper presents the development of a new algorithm to execute the task with wide graphic and analytic potentialities, thus transforming it into a very useful option for risk monitoring and the optimization of quality assurance. The system SECURE-MR, which is the basic software of this algorithm, has been successfully used in risk analysis regarding different kinds of radiotherapies. Compared to previous methods, It offers new possibilities of analysis considering risk controlling factors as the robustness of reducers of initiators frequency and its consequences. Their analytic capacities and graphs allow novel developments to classify risk contributing factors, to represent information processes as well as accidental sequences. The paper shows the application of the proposed system to a generic process of radiotherapy treatment using a lineal accelerator

          Related collections

          Most cited references12

          • Record: found
          • Abstract: found
          • Article: not found

          A method for evaluating quality assurance needs in radiation therapy.

          The increasing complexity of modern radiation therapy planning and delivery techniques challenges traditional prescriptive quality control and quality assurance programs that ensure safety and reliability of treatment planning and delivery systems under all clinical scenarios. Until now quality management (QM) guidelines published by concerned organizations (e.g., American Association of Physicists in Medicine [AAPM], European Society for Therapeutic Radiology and Oncology [ESTRO], International Atomic Energy Agency [IAEA]) have focused on monitoring functional performance of radiotherapy equipment by measurable parameters, with tolerances set at strict but achievable values. In the modern environment, however, the number and sophistication of possible tests and measurements have increased dramatically. There is a need to prioritize QM activities in a way that will strike a balance between being reasonably achievable and optimally beneficial to patients. A systematic understanding of possible errors over the course of a radiation therapy treatment and the potential clinical impact of each is needed to direct limited resources in such a way to produce maximal benefit to the quality of patient care. Task Group 100 of the AAPM has taken a broad view of these issues and is developing a framework for designing QM activities, and hence allocating resources, based on estimates of clinical outcome, risk assessment, and failure modes. The report will provide guidelines on risk assessment approaches with emphasis on failure mode and effect analysis (FMEA) and an achievable QM program based on risk analysis. Examples of FMEA to intensity-modulated radiation therapy and high-dose-rate brachytherapy are presented. Recommendations on how to apply this new approach to individual clinics and further research and development will also be discussed.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Failure mode and effect analysis-based quality assurance for dynamic MLC tracking systems.

            To develop and implement a failure mode and effect analysis (FMEA)-based commissioning and quality assurance framework for dynamic multileaf collimator (DMLC) tumor tracking systems. A systematic failure mode and effect analysis was performed for a prototype real-time tumor tracking system that uses implanted electromagnetic transponders for tumor position monitoring and a DMLC for real-time beam adaptation. A detailed process tree of DMLC tracking delivery was created and potential tracking-specific failure modes were identified. For each failure mode, a risk probability number (RPN) was calculated from the product of the probability of occurrence, the severity of effect, and the detectibility of the failure. Based on the insights obtained from the FMEA, commissioning and QA procedures were developed to check (i) the accuracy of coordinate system transformation, (ii) system latency, (iii) spatial and dosimetric delivery accuracy, (iv) delivery efficiency, and (v) accuracy and consistency of system response to error conditions. The frequency of testing for each failure mode was determined from the RPN value. Failures modes with RPN > or = 125 were recommended to be tested monthly. Failure modes with RPN < 125 were assigned to be tested during comprehensive evaluations, e.g., during commissioning, annual quality assurance, and after major software/hardware upgrades. System latency was determined to be approximately 193 ms. The system showed consistent and accurate response to erroneous conditions. Tracking accuracy was within 3%-3 mm gamma (100% pass rate) for sinusoidal as well as a wide variety of patient-derived respiratory motions. The total time taken for monthly QA was approximately 35 min, while that taken for comprehensive testing was approximately 3.5 h. FMEA proved to be a powerful and flexible tool to develop and implement a quality management (QM) framework for DMLC tracking. The authors conclude that the use of FMEA-based QM ensures efficient allocation of clinical resources because the most critical failure modes receive the most attention. It is expected that the set of guidelines proposed here will serve as a living document that is updated with the accumulation of progressively more intrainstitutional and interinstitutional experience with DMLC tracking.
              Bookmark
              • Record: found
              • Abstract: not found
              • Article: not found

              Patient safety in external beam radiotherapy-guidelines on risk assessment and analysis of adverse events and near misses

              (2013)
                Bookmark

                Author and article information

                Contributors
                Role: ND
                Role: ND
                Journal
                nuc
                Nucleus
                Nucleus
                CUBAENERGIA
                2075-5635
                December 2015
                : 0
                : 58
                : 39-46
                Article
                S0864-084X2015000200007
                5b880284-dae2-4bf5-b792-d1333e8b51e7

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Cuba

                Self URI (journal page): http://scielo.sld.cu/scielo.php?script=sci_serial&pid=0864-084X&lng=en
                Categories
                ENGINEERING, MULTIDISCIPLINARY
                NUCLEAR SCIENCE & TECHNOLOGY

                Nuclear chemistry,General engineering
                radiotherapy,risk assessment,hazards,linear accelerators,quality assurance,algorithms,radioterapia,valoración del riesgo,riesgos,aceleradores lineales,garantía de calidad,algoritmos

                Comments

                Comment on this article