Comparison of failure modes and effects analyses and time for brachytherapy ring and tandem applicator digitization...

Area of Science:

• Medical Physics
• Radiation Oncology
• Brachytherapy

Background:

• Manual digitization of ring and tandem (R&T) applicators is time-consuming and relies on subjective definition.
• Solid applicators offer predefined, 3D models with geometric constraints for potentially more efficient and standardized digitization.

Purpose of the Study:

• To compare the safety and efficiency of manual R&T applicator digitization with a novel solid applicator method.
• To assess the implementation suitability of the solid applicator method for R&T brachytherapy cases.

Main Methods:

• Failure Modes and Effects Analyses (FMEAs) were conducted by six qualified medical physicists (QMPs) and two residents using TG-100 guidelines.
• Comparative time studies were performed for both manual and solid applicator digitization processes.
• Risk Priority Numbers (RPNs) and digitization times were analyzed across participant groups and methods.

Main Results:

• QMPs found no significant difference in risk (RPNs) between manual and solid applicator methods, indicating non-inferiority.
• Digitization times were not significantly different between the two methods across all participants.
• Residents perceived higher risk with the solid applicator method, suggesting a learning curve.

Conclusions:

• The solid applicator method is non-inferior to manual digitization for R&T applicators regarding risk and time.
• Experience significantly influences FMEA evaluation and adoption of the solid applicator technique.
• Further practice with the solid applicator protocol is recommended to enhance familiarity, reduce perceived risk, and improve efficiency.