S1522
Interdisciplinary - Quality assurance and risk management
ESTRO 2026
significance for the combination of CAC and V50-LAD (p=0.027), suggesting that higher LAD doses and the presence of CAC increase cardiotoxicity risk.
groups and regulators in radiotherapy2,3, A method of detection (MD) is the process or point in the pathway where an event was identified4. The UK patient safety radiotherapy event (RTE) taxonomy includes 212 MD subcodes to describe this4. This original analysis aimed to interrogate the national ELS to identify the MD of radiation incidents and good catch events, highlighting the most effective mechanisms in identifying and preventing RTE. Material/Methods: An analysis of data voluntarily reported between August 2024 and July 2025 to the UK ELS was undertaken. RTE relating to equipment failure and malfunction were excluded from the analysis as these were generally detected immediately and may mask learning points. An analysis of the most frequently reported MD for radiation incidents and good catches was conducted. A radiation incident is defined as a radiotherapy event where the delivery of radiation is other than which was intended, and a good catch involves the interception and prevention of a potential radiation incident4. Results: In total there were 5,458 reports which met the criteria and were subject to analysis. The most frequently reported MD (56.0%) are associated with verification imaging, for radiation incidents (Figure 1). The most frequently reported MD for good catches (Figure 2) was patient positioning (8.2%). End of process checks (EOPC) can be assigned at the end of each discrete part of the pathway, these made up 6.4% of MD for radiation incidents and 15.9% MD for good catches.
Image 1. Coronary contouring using AI-assisted Slicer 3D Software Conclusion: High LAD doses and the presence of CAC on planning CT may help identify stage III NSCLC patients at increased risk of future cardiac events following thoracic chemoradiotherapy. These findings warrant validation in future studies and may integrated in the cardiovascular risk stratification to guide personalized cardio-oncology follow-up. References: McWilliam A, Abravan A, Banfill K, et al. Demystifying the Results of RTOG 0617: Identification of Dose Sensitive Cardiac Subregions Associated With Overall Survival. J Thorac Oncol. 2023;18(5):599-607. Lui M, Kim N, Zaghlol R, et al. Coronary artery calcium on lung cancer radiation planning CT aids cardiovascular risk assessment. Cardiooncology. 2024;10(1):80. Lyon AR, López-Fernández T, Couch LS, et al. 2022 ESC Guidelines on cardio-oncology developed in collaboration with the European Hematology Association (EHA), the European Society for Therapeutic Radiology and Oncology (ESTRO) and the International Cardio-Oncology Society (IC-OS). Eur Heart J. 2022;43(41):4229-4361. Keywords: Cardiotoxicity, lung cancer, CAC Difference in detection methods for radiation incidents vs good catches, a review of a national event learning system Helen Best, Cristiona Logan, John Rodgers, Una Findlay Medical Exposures Group, UKHSA, Oxford, United Kingdom Purpose/Objective: Event learning systems (ELS) are a fundamental component of safe practice1 and a widely accepted safety tool internationally advocated by professional Digital Poster Highlight 2670
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