Risk assessment of a new acceptance testing procedure for conventional linear accelerators

Harry, Taylor; Yaddanapudi, S; Cai, Bin; Stinson, Keith; Goddu, S; Noël, C.; Mutic, Sasa; Pawlicki, Todd

doi:10.1002/mp.12527

Cited by 5 publications

(5 citation statements)

References 19 publications

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“…This observation agrees well with other studies reported in the literature that demonstrate that automating the ATC process and using standard beam data reduces the probability of occurrence of errors . A comparison of using manufacturer‐supplied phantom and automation (with EPID) vs conventional techniques with tools that are not an integral part of the linac has shown that use of manufacturer‐supplied phantoms and automation reduces the number of FMs by slightly more than half, from 556 FMs to 255 FMs, for a c‐arm linac …”

Section: Discussionsupporting

confidence: 90%

“…17,18 A comparison of using manufacturer-supplied phantom and automation (with EPID) vs conventional techniques with tools that are not an integral part of the linac has shown that use of manufacturer-supplied phantoms and automation reduces the number of FMs by slightly more than half, from 556 FMs to 255 FMs, for a c-arm linac. 5 In the conventional approach of measurements of output in a c-arm linac, a reference detector is typically placed between the linac head and a water tank. However, due to the space limitation of the ring-gantry linac, the reference detector could not be positioned on the water tank and it was instead attached to the bore cover with a tape (Fig.…”

Section: Rankmentioning

confidence: 99%

“…These FMs were not identified in previous studies conducted on c-arm linacs. 4,5,18 A possible quality control measure for this machine-related FM is for the manufacturer to mark an approximate 5 9 5 cm 2 , and 10 9 10 cm 2 field on the bore cover.…”

Section: Rankmentioning

confidence: 99%

“…Failure modes and effects analysis (FMEA) has been used to assess the risks of various aspects of ATC including: (a) the use of an electronic portal imaging device (EPID) for the acceptance testing of the c‐arm TrueBeam linac, and (b) a comparative study using both conventional procedures and EPID for the acceptance testing of c‐arm linacs . The present work uses TG100 recommended methodology for performing risk analysis of the ATC process (a) of a new type of preassembled ring‐gantry linac (Varian Halcyon) that relies heavily on automation and EPID for ATC, and (b) for performing ATC that incorporates manufacturer's ATC instructions where some instructions are different from guidance given in conventional protocols recommended by, for example, the AAPM .…”

Section: Introductionmentioning

confidence: 99%

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Application of TG‐100 risk analysis methods to the acceptance testing and commissioning process of a Halcyon linear accelerator

Teo

Hwang

Shields³

et al. 2019

Medical Physics

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Purpose A new type of linear accelerator (linac) was recently introduced into the market by a major manufacturer. Our institution is one of the early users of this preassembled and preconfigured dual‐layer multileaf collimator (MLC), ring‐gantry linac — Halcyon™ (1st version). We performed a set of full acceptance testing and commissioning (ATC) measurements for three Halcyon machines and compared the measured data with the standard beam model provided by the manufacturer. The ATC measurements were performed following the guidelines given in different AAPM protocols as well as guidelines provided by the manufacturer. The purpose of the present work was to perform a risk assessment of the ATC process for this new type of linac and investigate whether the results obtained from this analysis could potentially be used as a guideline for improving the design features of this type of linac. Methods AAPM's TG100 risk assessment methodology was applied to the ATC process. The acceptance testing process relied heavily on the use of a manufacturer‐supplied phantom and the automated analysis of electronic portal imaging device (EPID) images. For the commissioning process, a conventional measurement setup and process (e.g., use of water tank for scanning) was largely used. ATC was performed using guidelines recommended in various AAPM protocols (e.g., TG‐106, TG‐51) as well as guidelines provided by the manufacturer. Six medical physicists were involved in this study. Process maps, process steps, and failure modes (FMs) were generated for the ATC procedures. Failure modes and effects analysis (FMEA) were performed following the guidelines given in AAPM TG‐100 protocol. The top 5 and top 10 highest‐ranked FMs were identified for the acceptance and commissioning procedures, respectively. Quality control measures were suggested to mitigate these FMs. Results A total of 38 steps and 88 FMs were identified for the entire ATC process. Fourteen steps and 34 FMs arose from acceptance testing. The top 5 FMs that were identified could potentially be mitigated by the manufacturer. For commissioning, a total of 24 steps and 54 potential FMs were identified. The use of separate measurement tools that are not machine‐integrated has been identified as a cause for the higher number of steps and FMs generated from the conventional ATC approach. More than half of the quality control measures recommended for both acceptance and commissioning could potentially be incorporated by the manufacturer in the design of the Halcyon machine. Conclusion This paper presents the results of FMEA and quality control measures to mitigate the FMs for the ATC process for Halcyon machine. Unique FMs that result from the differences in the ATC guidelines provided by the vendor and current conventional protocols, and the challenges of performing the ATC due to the new linac features and ring‐gantry design were highlighted for the first time. The FMs identified in the present work along with the suggested quality control measures, could potentially be used to impro...

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Section: Discussionsupporting

confidence: 90%

Section: Rankmentioning

confidence: 99%

Section: Rankmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Application of TG‐100 risk analysis methods to the acceptance testing and commissioning process of a Halcyon linear accelerator

Teo

Hwang

Shields³

et al. 2019

Medical Physics

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“…Uma das ferramentas de análise de risco elencadas no TG-100 é a Failure Modes and Effects Analysis (FMEA), já amplamente utilizada na indústria e na engenharia. Atualmente, em um serviço de radioterapia, é possível aplicar esta metodologia a diferentes equipamentos, não só os contemplados no SEVRRA, além da ampla possibilidade de uso desta análise em diferentes técnicas de tratamento, processos e até mesmo em procedimentos de controle de qualidade [9], [10], [11].…”

Section: Introductionunclassified

Análise de riscos FMEA vs. SEVRRA em tratamentos radioterápicos com equipamentos de quilovoltagem

et al. 2019

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Os tratamentos radioterápicos devem oferecer segurança ao paciente. Porém, falhas podem ocorrer e desencadear exposições acidentais. Neste trabalho foi realizada análise de riscos prospectiva das etapas no processo de tratamento com quilovoltagem, utilizando a FMEA e o SEVRRA. Inicialmente foi elaborado o mapa de processos e os modos de falha envolvidos. Posteriormente foi aplicada a FMEA e, mediante resultados médios obtidos nesta análise, realizou-se outra análise com base no SEVRRA para comparar a efetividade dessas ferramentas. Entrevistas foram feitas com os profissionais envolvidos, levantamento dos modos de falhas, pontuação dos riscos e levantamento das barreiras. A análise FMEA mostrou que 39% dos modos de falha apresentam (NPR)≥100, sendo este limite escolhido mais conservador. A análise SEVRRA demonstrou que 16% dos modos de falha apresentam riscos altos, 51% riscos moderados, 33% riscos baixos e nenhuma falha considerada de risco muito alto. Apesar da análise FMEA e SEVRRA ser diferente os riscos considerados altos e médios pelo SEVRRA estão contemplados pelo FMEA com NPR≥100 e, que apesar de haver alguns modos de falha de Risco Alto no SEVRRA, a frequência em que eles ocorrem é baixa. Os métodos são complementares e importantes para identificação de possíveis falhas ou erros em Radioterapia.

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Benchmarking failure mode and effects analysis of electronic brachytherapy with data from incident learning systems

2021

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Risk assessment of a new acceptance testing procedure for conventional linear accelerators

Cited by 5 publications

References 19 publications

Application of TG‐100 risk analysis methods to the acceptance testing and commissioning process of a Halcyon linear accelerator

Application of TG‐100 risk analysis methods to the acceptance testing and commissioning process of a Halcyon linear accelerator

Análise de riscos FMEA vs. SEVRRA em tratamentos radioterápicos com equipamentos de quilovoltagem

Benchmarking failure mode and effects analysis of electronic brachytherapy with data from incident learning systems

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