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Introduction:Magnetic Resonance Imaging, or MRI, can include a specialized imaging technique of the urinary system known as Magnetic Resonance Urography (MRU). This radiation-free technique uses strong magnetic fields and radio waves to produce detailed images with the help of a computer. MRU is particularly effective for visualizing fluid-filled structures like the kidneys, ureters, and bladder.Applications of MRI in the Genitourinary SystemKidneys and Ureters: MRI detects tumors, cysts,...
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Fuzzy Analytical Hierarchy Process-based Risk Priority Number Approach in Failure Modes and Effects Analysis for

Jina Chang1, Hayeon Kim2, Ron Lalonde1

  • 1Department of Radiation Oncology, University of Pittsburgh Medical Center, Shadyside Hospital, Pittsburgh, Pennsylvania.

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|March 19, 2025
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Summary

A new fuzzy analytical hierarchy process (AHP)-based risk priority number (RPN) method effectively prioritizes failure modes in MRI-guided gynecologic (GYN) brachytherapy (BT). This approach improves upon traditional FMEA by better handling process interdependencies for enhanced safety.

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Area of Science:

  • Medical Physics
  • Radiation Oncology
  • Quality Improvement

Background:

  • Traditional Failure Modes and Effects Analysis (FMEA) using Risk Priority Numbers (RPN) has limitations in addressing process interdependencies.
  • Accurate identification and mitigation of failure modes are critical for patient safety in complex procedures like Magnetic Resonance Imaging (MRI)-guided gynecologic (GYN) high-dose-rate brachytherapy (BT).
  • Existing methods may not adequately capture the nuanced risks associated with interdependencies in clinical workflows.

Purpose of the Study:

  • To propose and evaluate a novel fuzzy Analytical Hierarchy Process (AHP)-based RPN method for prioritizing failure modes (FMs) in MRI-guided GYN BT.
  • To enhance the accuracy of risk assessment by better incorporating interdependencies within the clinical process.
  • To provide a more effective tool for risk mitigation in advanced radiation oncology procedures.

Main Methods:

  • A comprehensive process map of MRI-based GYN BT was developed, identifying potential FMs.
  • A fuzzy AHP-based RPN method was applied, grouping substeps by job specialty and using fuzzy linguistic terms to manage uncertainty.
  • Evaluators completed questionnaires for both conventional FMEA and the new fuzzy AHP-based RPN analysis.

Main Results:

  • The fuzzy AHP-based RPN analysis identified the top 5 FMs, including incorrect applicator insertion and reconstruction, and issues with dose-volume histogram and contours.
  • Conventional FMEA yielded a different ranking of top FMs, highlighting discrepancies in risk prioritization.
  • Significant rank differences were observed for FMs related to applicator insertion and MRI, indicating the improved sensitivity of the fuzzy AHP method.

Conclusions:

  • The fuzzy AHP-based RPN method is feasible and effective for prioritizing FMs in the clinical workflow of MRI-guided GYN BT.
  • This approach offers a valuable improvement over traditional FMEA for risk assessment in this specific clinical context.
  • The study provides a strong reference for implementing advanced fuzzy AHP-based risk assessment in MRI-guided brachytherapy.