{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T03:02:31Z","timestamp":1789700551487,"version":"4.0.1"},"reference-count":13,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Risk analysis is becoming increasingly important in advanced radiotherapy, as treatment workflows grow more complex and require multidisciplinary expertise. Although failure mode and effects analysis (FMEA) has been recommended for risk\u2010based quality management, opportunities for users to practically learn and apply FMEA within CyberKnife\u00ae workflows remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate the feasibility and educational value of a group\u2010based, hands\u2010on seminar for teaching FMEA methodology in CyberKnife\u00ae stereotactic radiotherapy, using four representative treatment sites as practical examples.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A half\u2010day seminar was conducted for eight radiation technologists and six medical physicists from CyberKnife\u00ae institutions, supported by four facilitators. Following a didactic lecture on risk analysis, participants were divided into four site\u2010specific groups (intracranial, lung, spine, and prostate). Each group utilized institution\u2010prepared process maps and a shared Excel\u2010based worksheet to identify potential failure modes, score them using a five\u2010point FMEA scale for occurrence, severity, and detectability, and discuss possible countermeasures. Risk priority numbers (RPNs) were calculated to rank the identified failure modes. A postseminar questionnaire was administered to assess participants\u2019 prior experience, level of understanding of risk analysis, and willingness to implement it in clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The seminar generated site\u2010specific failure mode lists as educational outputs. The highest\u2010ranked risks were contouring errors for intracranial lesions (RPN 48), irregular respiration for lung lesions (RPN 64), pain\u2010induced patient motion for spinal lesions (RPN 36), and target delineation errors for prostate lesions (RPN 80). Other major risks included inappropriate selection of immobilization devices, prescription and fractionation errors, tracking\u2010related issues, image registration inaccuracies, and incorrect patient\u2010specific QA evaluation criteria. Thirteen participants completed the questionnaire. Most participants had limited prior experience with risk analysis; however, 85% reported a good level of understanding after the seminar, and 92% expressed willingness to implement risk analysis at their institutions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This group\u2010based seminar provided participants with practical experience in applying FMEA to CyberKnife treatment workflows. The questionnaire responses suggested that most participants gained a better understanding of risk analysis and were interested in applying it at their own institutions. The failure mode lists generated during the seminar were not intended to represent a complete FMEA for any participating institution but may provide practical examples for initiating multidisciplinary risk analysis based on local workflows and clinical practices.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acm2.70789","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T07:14:01Z","timestamp":1789024441000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A group\u2010based hands\u2010on seminar for teaching failure mode and effects analysis in CyberKnife stereotactic radiotherapy"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9491-787X","authenticated-orcid":false,"given":"Hiroyuki","family":"Okamoto","sequence":"first","affiliation":[{"name":"Section of Radiation Safety and Quality Assurance National Cancer Center Hospital  Tsukiji, Chuo\u2010ku Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3484-5805","authenticated-orcid":false,"given":"Shie","family":"Nishioka","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Japanese Red Cross Kyoto Daini Hospital  Kamigyo\u2010ku, Kyoto Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Kamomae","sequence":"additional","affiliation":[{"name":"Medical Branch, Radioisotope\u00a0Research Center Nagoya\u00a0University  Showa\u2010ku, Nagoya Aichi Japan"},{"name":"Department of Radiology Nagoya University Graduate School of Medicine  Showa\u2010ku, Nagoya Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2805-0427","authenticated-orcid":false,"given":"Kohei","family":"Okawa","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy Quality Management Shinryoku Neurosurgical Clinic, Yokohama CyberKnife Center  Yokohama Kanagawa Japan"},{"name":"Faculty of Health Sciences Butsuryo College of Osaka  Sakai Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Souichi","family":"Kikuchi","sequence":"additional","affiliation":[{"name":"Division of Health Sciences, Graduate School of Medical Sciences Kanazawa University Kanazawa Ishikawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junji","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Radiotherapy Quality Management Group TOYOTA Memorial Hospital  Toyota Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.4947547"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.14992"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.3190392"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.3579139"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.17478"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2007.08.081"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13014-015-0438-0"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.4735788"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clon.2017.07.009"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.70095"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.13850"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.zemedi.2022.11.004"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2009.12.040"}],"container-title":["Journal of Applied Clinical Medical Physics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acm2.70789","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/acm2.70789","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acm2.70789","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T02:07:48Z","timestamp":1789697268000},"score":1,"resource":{"primary":{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/10.1002\/acm2.70789"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":13,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/acm2.70789"],"URL":"https:\/\/doi.org\/10.1002\/acm2.70789","archive":["Portico"],"relation":{},"ISSN":["1526-9914","1526-9914"],"issn-type":[{"value":"1526-9914","type":"print"},{"value":"1526-9914","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2026-04-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70789"}}