Article

Probabilistic risk assessment of radiotherapy application

¹ Department of Radiation Onkology, IEU Medicalpark Hospital, Karşıyaka 35575, İzmir, Turkey
² Vocational School of Health Services, İzmir University of Economics, Balçova 35330, İzmir, Turkey
³ Department of Medical Physics, Health Sciences Institute, Dokuz Eylul University, Inciralti 35340, İzmir, Turkey
⁴ Oak Ridge National Laboratory, Oak Ridge 37830, United States
⁵ Department of Nuclear Sciences, Ege University, Bornova 35100, İzmir, Turkey

^* Corresponding author: cozbay@mntsaglik.com.tr

Received: 25 July 2021
Accepted: 26 December 2021

Abstract

The recent rapid development and increasing complexity of radiotherapy devices and applications has increased the importance of correct and safe treatment. Risk management is very important in radiotherapy (RT), because incorrect treatment can have serious consequences in terms of mortality or morbidity. However, there are currently few studies on risk analysis in RT. This quantitative and qualitative study of the radiotherapy system (all radiotherapy process) uses the fault tree method, one of the probabilistic risk assessment methods in radiotherapy applications, which is used to devise accident preventive actions. First of all, RT applications were divided into simulation, treatment planning and treatment delivery. For each, work flow charts were determined, and fault trees were created in SAPHIRE (Systems Analysis Programs for Hands-on Integrated Reliability Evaluations) software. Fault probabilities were determined using the expert judgment method. This analysis allowed the identification of the weak points of the system, both qualitatively and quantitatively. The analyzes also revealed that there was a 0.5% occurrence probability of a top event, determined as an incorrect dose or dose distribution in RT. It was determined that the greatest contribution to this probability value was matching error with image guidance, 7.88%. Fault tree analysis (FTA) was found to facilitate a detailed examination of the radiotherapy system. After the risk analysis, the appropriate quality control method for weak points should be determined and implemented for safety management in radiotherapy.