scholarly journals A bi-institutional multi-disciplinary failure mode and effects analysis (FMEA) for a Co-60 based total body irradiation technique

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Shahbaz Ahmed ◽  
Todd Bossenberger ◽  
Adrian Nalichowski ◽  
Jeremy S. Bredfeldt ◽  
Sarah Bartlett ◽  
...  
Keyword(s):  
Failure Mode ◽  
Total Body Irradiation ◽  
Failure Modes ◽  
Quantitative Estimation ◽  
Treatment Quality ◽  
Treatment Delivery ◽  
Medical Physicists ◽  
Prospective Risk ◽  
New Treatment ◽  
Total Body

Abstract Background We aim to assess the risks associated with total body irradiation (TBI) delivered using a commercial dedicated Co-60 irradiator, and to evaluate inter-institutional and inter-professional variations in the estimation of these risks. Methods A failure mode and effects analysis (FMEA) was generated using guidance from the AAPM TG-100 report for quantitative estimation of prospective risk metrics. Thirteen radiation oncology professionals from two institutions rated possible failure modes (FMs) for occurrence (O), severity (S), and detectability (D) indices to generate a risk priority number (RPN). The FMs were ranked by descending RPN value. Absolute gross differences (AGD) in resulting RPN values and Jaccard Index (JI; for the top 20 FMs) were calculated. The results were compared between professions and institutions. Results A total of 87 potential FMs (57, 15, 10, 3, and 2 for treatment, quality assurance, planning, simulation, and logistics respectively) were identified and ranked, with individual RPN ranging between 1–420 and mean RPN values ranging between 6 and 74. The two institutions shared 6 of their respective top 20 FMs. For various institutional and professional comparison pairs, the number of common FMs in the top 20 FMs ranged from 6 to 13, with JI values of 18–48%. For the top 20 FMs, the trend in inter-professional variability was institution-specific. The mean AGD values ranged between 12.5 and 74.5 for various comparison pairs. AGD values differed the most for medical physicists (MPs) in comparison to other specialties i.e. radiation oncologists (ROs) and radiation therapists (RTs) [MPs-vs-ROs: 36.3 (standard deviation SD = 34.1); MPs-vs-RTs: 41.2 (SD = 37.9); ROs-vs-RTs: 12.5 (SD = 10.8)]. Trends in inter-professional AGD values were similar for both institutions. Conclusion This inter-institutional comparison provides prospective risk analysis for a new treatment delivery unit and illustrates the institution-specific nature of FM prioritization, primarily due to operational differences. Despite being subjective in nature, the FMEA is a valuable tool to ensure the identification of the most significant risks, particularly when implementing a novel treatment modality. The creation of a bi-institutional, multidisciplinary FMEA for this unique TBI technique has not only helped identify potential risks but also served as an opportunity to evaluate clinical and safety practices from the perspective of both multiple professional roles and different institutions.

A Novel Translational Total Body Irradiation Technique

2010 ◽  
Vol 4 (3) ◽  
Author(s):  
Derek W. Brown ◽  
Kurt Knibutat ◽  
Nathan Edmonds ◽  
Daniel Tom ◽  
Leo Moriarty ◽  
...  
Keyword(s):  
Total Body Irradiation ◽  
Radiation Beam ◽  
Treatment Delivery ◽  
Beam Shape ◽  
Delivery Technique ◽  
Irradiation Treatment ◽  
Dose Homogeneity ◽  
Total Body ◽  
Interlock System ◽  
Beam Technique

A novel translating bed total body irradiation treatment delivery technique that employs dynamically shaped beams is presented. The patient is translated along the floor on a moving bed through a stationary radiation beam and the shape of the radiation beam is changed dynamically as the patient is moved through it, enabling compensation for local variations in patient thickness and tissue density. We demonstrate that the use of dynamically shaped beams results in greatly improved dose homogeneity compared with standard techniques, which use a single static beam shape. Along a representative dose profile through the lungs of a mock-human body, the maximum range of dose deviation from the average is 5.6% (from +2.7% to −2.9%) for the dynamic beam technique compared with 12.8% (from +3.6% to −9.2%) for the static beam technique. A novel, dual-interlock system that prevents bed motion when the radiation beam is stopped and stops the radiation beam when the bed motor is stopped has also been developed. The dual-interlock not only enhances the safety of the treatment but also ensures accuracy in the delivery of the treatment.

scholarly journals Current practice in total-body irradiation: results of a Canada-wide survey

2017 ◽  
Vol 24 (3) ◽  
pp. 181 ◽  
Author(s):  
R.C.N. Studinski ◽  
D.J. Fraser ◽  
R.S. Samant ◽  
M.S. MacPherson
Keyword(s):  
Total Body Irradiation ◽  
Best Practice ◽  
Current Practice ◽  
Organs At Risk ◽  
Treatment Strategies ◽  
Marrow Transplant ◽  
Treatment Delivery ◽  
Current State ◽  
Total Body ◽  
Question Survey

Background Total-body irradiation (tbi) is used to condition patients before bone marrow transplant. A variety of tbi treatment strategies have been described and implemented, but no consensus on best practice has been reached. We report on the results of a survey created to assess the current state of tbi delivery in Canada.Results A 19-question survey was distributed to 49 radiation oncology programs in Canada. Responses were received from 20 centres, including 12 centres that perform tbi. A variety of tbi dose prescriptions was reported, although 12 Gy in 6 fractions was used in 11 of the 12 centres performing tbi. Half of the centres also reported using a dose prescription unique to their facility.Most centres use an extended-distance parallel-opposed-pair technique, with the patient standing or lying on a stretcher against a wall. Others translate the patient under the beam, sweep the beam over the patient, or use a more complicated multi-field technique. All but 1 centre indicated that they attenuate the lung dose; only 3 centres indicated attenuating the dose for other organs at risk. The survey also highlighted the considerable resources used for tbi, including extra staff, prolonged planning and treatment times, and use of locally developed hardware or software.Conclusions At transplant centres, tbi is commonly used, but there is no commonly accepted approach to planning and treatment delivery. The important discrepancies in practice between centres in Canada creates an opportunity to prompt more discussion and collaboration between centres, improving consistency and uniformity of practice.

Combine Nanoprobing Technique with Difference Analysis to Identify Nonvisual Failures

2006 ◽  
Author(s):  
Cha-Ming Shen ◽  
Tsan-Cheng Chuang ◽  
Jie-Fei Chang ◽  
Jin-Hong Chou
Keyword(s):  
Failure Mode ◽  
Failure Modes ◽  
Electrical Characteristic ◽  
The Novel ◽  
Difference Analysis ◽  
Original Idea ◽  
Deductive Method ◽  
Complete Measurement

Abstract This paper presents a novel deductive methodology, which is accomplished by applying difference analysis to nano-probing technique. In order to prove the novel methodology, the specimens with 90nm process and soft failures were chosen for the experiment. The objective is to overcome the difficulty in detecting non-visual, erratic, and complex failure modes. And the original idea of this deductive method is based on the complete measurement of electrical characteristic by nano-probing and difference analysis. The capability to distinguish erratic and invisible defect was proven, even when the compound and complicated failure mode resulted in a puzzling characteristic.

Case Study and Fault Modeling for Wrong Redundancy Evaluation on DRAM Devices

2007 ◽  
Author(s):  
Martin Versen ◽  
Dorina Diaconescu ◽  
Jerome Touzel
Keyword(s):  
Failure Mode ◽  
Failure Modes ◽  
Fault Modeling ◽  
Mode Analysis ◽  
Root Cause ◽  
Failure Mode Analysis

Abstract The characterization of failure modes of DRAM is often straight forward if array related hard failures with specific addresses for localization are concerned. The paper presents a case study of a bitline oriented failure mode connected to a redundancy evaluation in the DRAM periphery. The failure mode analysis and fault modeling focus both on the root-cause and on the test aspects of the problem.

Methodology for Analysis of Schottky Diode Failures

2010 ◽  
Author(s):  
Bhanu P. Sood ◽  
Michael Pecht ◽  
John Miker ◽  
Tom Wanek
Keyword(s):  
Failure Mode ◽  
Schottky Diode ◽  
Failure Modes ◽  
Schottky Diodes ◽  
Failure Mechanisms ◽  
Forward Voltage ◽  
Fast Switching ◽  
Voltage Drops ◽  
The Common

Abstract Schottky diodes are semiconductor switching devices with low forward voltage drops and very fast switching speeds. This paper provides an overview of the common failure modes in Schottky diodes and corresponding failure mechanisms associated with each failure mode. Results of material level evaluation on diodes and packages as well as manufacturing and assembly processes are analyzed to identify a set of possible failure sites with associated failure modes, mechanisms, and causes. A case study is then presented to illustrate the application of a systematic FMMEA methodology to the analysis of a specific failure in a Schottky diode package.

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