Workflow efficiency for the treatment planning process in CT-guided high-dose-rate brachytherapy for cervical cancer

Anthony L. Michaud, Stanley H Benedict, Eliseo Montemayor, Jon Paul Hunt, Cari Wright, Mathew Mathai, Jyoti S. Mayadev

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Purpose: To investigate process efficiency, we present a prospective investigation of the treatment planning phase of image-guided brachytherapy (BT) for cervical cancer using a specific checklist. Methods and Materials: From October 2012 to January 2014, 76 BT procedures were consecutively performed. Prospective data on the CT-based treatment planning process was collected using a specific checklist which details the following steps: (1) dosimetry planning, (2) physician review start, (3) physician review time, (4) dosimetry processing, (5) physics review start, (6) physics review, and (7) procedural pause. Variables examined included the use of a pre-BT MRI, clinic duty conflicts, resident teaching, and the use of specific BT planners. Analysis was performed using descriptive statistics, . t-test, and analysis of variance. Results: Seventy-five prospectively gathered checklists comprised this analysis. The mean time for treatment planning was 95 minutes (med 94, std 18). The mean intervals in the above steps were (1) = 42, (2) = 5, (3) = 19, (4) = 10, (5) = 6, (6) = 13, and (7) = 26 minutes. There was no statistical difference in patients who had a pre-BT MRI. Resident teaching did not influence time, . p = 0.17. Treatment planning time was decreased with a specific planner, . p = 0.0015. Conclusions: A skillful team approach is required for treatment planning efficiency in image-guided BT. We have found that the specific BT planners can have a significant effect on the overall planning efficiency. We continue to examine clinical and workflow-related factors that will enhance our safety and workflow process with BT.

Original languageEnglish (US)
StateAccepted/In press - May 17 2016


  • Brachytherapy
  • Cervical cancer
  • Process efficiency
  • Workflow

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging


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