Novel Number-Color Code System for Improving Catheter Identification in Gynecologic Brachytherapy

A novel number-color code system was developed to enhance brachytherapy catheter identification. Radiopaque buttons with unique number-color combinations and number tags were used for freehand and template-based catheters, respectively, replacing handwritten adhesive labels. A multidisciplinary survey was conducted to assess its accuracy, ease of use, speed, and user confidence and compare the new and previous methods after 1 year on a five-point Likert scale. Twenty-two staff members (5 radiation oncologists, 7 radiation therapy technologists, 4 nurses, 5 medical physicists, and 1 dosimetrist) participated. No incorrect identification was reported with either method. Personnel with direct applicator contact rated the new system higher on all aspects for freehand catheters. Medical physicists and dosimetrists also gave higher ratings but noted the radiologic invisibility of the colors and suggested shape coding. The most common issue was button positioning. For template-based catheters, number tags were preferred over adhesive labels. To address legibility issues, participants suggested enlarging tags or engraving numbers. The findings indicate that our novel number-color code system is simple and well-accepted by users. Further studies should define objective measures and develop more robust identification labels.