2016 Risk Course Book

Taxonomies and Severity Scales

TG 100’s Process Tree

Immobilization and positioning

Initial treatment planning directive

Immobilization equipment fabricated

Plan prep

Immobilization equipment documented, labeled, andstored

Enterdemographics, 49

Specify registrationgoals 23, 37

Specify images for target/structuredelineation 11

Transferpatientdata to treatmentdelivery 15

Patient database information entered

PrepareDRR andother images 50

Specifyprotocol fordelineating target and structures 17

Manualdata entry andplanmodification 39

Data intoelectronic Database 21

SpecifyROI foroptimization 18

Specify treatment course

Indicatemotion/uncertainty Management 13 Special Instructions (pacemakers, allergies, preps,etc.) 9 Suggest initialguidelines for treatmentparameters Account forprevious treatments orchemotherapy 4

Treatment planning

Data intowritten chart 21

Automatic data entry andplanmodification

Setup fields Setupdose calcparameters Optimization/Dose calculation 12, 29, 31

Informationonprevious orconcomitant treatment 8

Chart filing

Deliveryprotocols

Imaging and diagnosis

Scheduling

OptimizationROI 18, 33, 44 Optimization settings 22, 45, 51

Reviewofpatient medicalhistory

Check versionof plan andpatient ID 7

Run leaf sequencer 54

Enterprescription 19, 47

Specifydose limits andgoals 26

Evaluateplan 10, 28

Successful treatment

Documentation

ConstructBlocks Compensators Bolus,Etc

Booleanoperations 30, 46

Transfer images andother DICOMdata:primary and secondarydata transferred 41

MonitorPt/Tx 38, 42

Treatment 3

Dosimetry Physics MD

SpecifyPTVMargin

Treatment preparation

Changesnoted 32,34 Changes correct 40, 43

ApprovePlan FinalPrescription

Protocol forPTV Margin 6, 48

ImagingStudies

Scheduling for planning process

Motion Management 8

PTVconstruction Editdensitymap for artifacts DelineateROIs and planning structures

Plan Approval

Treatment review

Immobilization equipment documented, labeled, and stored

Treatment accessories 24

Imaging

Positioning

Immobilization for Imaging study

Pt changesnoted 55

MD : delineate GTV/CTV 1,2,5, 53, 56 Protocol fordelineation of targets 9,17

Decisionofprotocol

Ptprep 35,52

Decisionof treatment technique

Immobilization equipment fabricated

Scheduling

4D imaging correct 14

Subsequent treatments

Patientprepped (contrast, tattoos, BBs etc.)

Select Images 25

Documentation

Import and fuse images 16

MonitorPt/Tx 38

Setupdata documented

Consultation and decision to treat

Treatment 3

TxUnitoperation and calibration 3

Patient Identified

RTP anatomy contouring

Motionmanagement 8 Treatment settings

Treatmentaccessories 24

Imaging (CT/PET/MR)

Positioning Imaging (port films,CBCT,etc) 27

Ptprep 35

Timeout

Patient ID TreatmentSite

Treatment settings

Initial treatment

Huq MS, Fraass BA, Dunscombe P, et al. The report of Task Group 100 of the AAPM: Application of risk analysis methods to radiation therapy quality management. Medical Physics 43, 4209 – 4262. 2016.

Taxonomy Review: Process maps »Severity »Causes »Barriers

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