Minimizing treatment planning errors in proton therapy using failure mode and effects analysis.

Area of Science:

• Medical Physics
• Radiation Oncology
• Quality Improvement

Background:

• Failure Mode and Effects Analysis (FMEA) is established for photon therapy safety but underutilized in proton therapy.
• Proton therapy offers advanced treatment capabilities but requires rigorous safety protocols.
• Identifying and mitigating potential failures in proton treatment planning is crucial for patient safety.

Purpose of the Study:

• To apply FMEA to enhance the safety of proton therapy treatment planning.
• To systematically identify and assess potential failure modes within the proton therapy planning process.

Main Methods:

• Performed FMEA on the proton therapy treatment planning process using uniform scanning beams.
• Identified failure modes across image fusion, contouring, beam arrangement, dose calculation, and plan export.
• Calculated Risk Priority Numbers (RPN) based on occurrence, detectability, and severity; established an error tracking database.

Main Results:

• Over 36 potential treatment planning failure modes were identified and risk-assessed using FMEA.
• Safety improvements including education, peer review, and automated checks were implemented based on FMEA findings.
• An error tracking database provided data for ongoing RPN reevaluation and quality assurance program refinement.

Conclusions:

• FMEA offers a systematic approach to preemptively identify and evaluate errors in proton treatment planning.
• Integrating FMEA with an ongoing error tracking system effectively reduces errors in proton treatment planning.
• These methods enhance the overall safety and effectiveness of proton therapy delivery.