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image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Medical Physicsarrow_drop_down
image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao
Medical Physics
Article . 2025 . Peer-reviewed
License: Wiley Online Library User Agreement
Data sources: Crossref
Medical Physics
Article . 2025
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Dose to circulating blood in intensity‐modulated total body irradiation, total marrow irradiation, and total marrow and lymphoid irradiation

Authors: Bingqi, Guo; Sheen, Cherian; Erin S, Murphy; Craig S, Sauter; Ronald M, Sobecks; Seth, Rotz; Rabi, Hanna; +2 Authors

Dose to circulating blood in intensity‐modulated total body irradiation, total marrow irradiation, and total marrow and lymphoid irradiation

Abstract

Abstract Background Multi‐isocentric intensity‐modulated (IM) total body irradiation (TBI), total marrow irradiation (TMI), and total marrow and lymphoid irradiation (TMLI) are gaining popularity. A question arises on the impact of the interplay between blood circulation and dynamic delivery on blood dose. Purpose This study answers the question by introducing a new whole‐body blood circulation modeling technique. Methods A whole‐body CT with intravenous contrast was used to develop the blood circulation model. Fifteen organs and tissues, heart chambers, and great vessels were segmented using a deep‐learning‐based auto‐contouring software. The main blood vessels were segmented using an in‐house algorithm. Blood density, velocity, time‐to‐heart, and perfusion distributions were derived for systole, diastole, and portal circulations and used to simulate trajectories of blood particles during delivery. With the same prescription of 12 Gy in 8 fractions, doses to circulating blood were calculated for three plans: (1) an IM‐TBI plan prescribing uniform dose to the whole body while reducing lung and kidney doses; (2) a TMI plan treating all bones; and (3) a TMLI plan treating all bones, major lymph nodes, and spleen; TMI and TMLI plans were optimized to reduce doses to non‐target tissue. Results Circulating blood received 1.57 ± 0.43 Gy, 1.04 ± 0.32 Gy, and 1.09 ± 0.32 Gy in one fraction and 12.60 ± 1.21 Gy, 8.34 ± 0.88 Gy, and 8.71 ± 0.92 Gy in 8 fractions in IM‐TBI, TMI, and TMLI, respectively. The interplay effect of blood motion with IM delivery did not change the mean dose, but changed the dose heterogeneity of the circulating blood. Fractionation reduced the blood dose heterogeneity. Conclusions A novel whole‐body blood circulating model was developed based on patient‐specific anatomy and realistic blood dynamics, concentration, and perfusion. Using the blood circulation model, we developed a dosimetry tool for circulating blood in IM‐TBI, TMI, and TMLI.

Related Organizations
Keywords

Blood, Bone Marrow, Radiotherapy Planning, Computer-Assisted, Blood Circulation, Humans, Radiotherapy Dosage, Radiotherapy, Intensity-Modulated, Radiation Dosage, Whole-Body Irradiation

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
3
Top 10%
Average
Average
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