The Thoracic Absorption Dose and Secondary Tumor Risk Caused by Different Imaging Methods in Image‐Guided Particle Radiotherapy
ABSTRACT Background Image‐guided radiation therapy uses imaging methods such as CBCT to effectively improve treatment precision. Kilovoltage‐imaging technology provides high soft tissue contrast at low doses, whereas megavoltage‐imaging technology better displays deep and bony structures at high dos...
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| Format: | Article |
| Language: | English |
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Wiley
2025-06-01
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| Series: | Thoracic Cancer |
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| Online Access: | https://doi.org/10.1111/1759-7714.70102 |
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| author | Qinghao Cui Xianrui Yan Chengqiang Li Jian Zhu Jun Ma Tingting Liu |
| author_facet | Qinghao Cui Xianrui Yan Chengqiang Li Jian Zhu Jun Ma Tingting Liu |
| author_sort | Qinghao Cui |
| collection | DOAJ |
| description | ABSTRACT Background Image‐guided radiation therapy uses imaging methods such as CBCT to effectively improve treatment precision. Kilovoltage‐imaging technology provides high soft tissue contrast at low doses, whereas megavoltage‐imaging technology better displays deep and bony structures at high doses. Proton therapy is more sensitive to tissue density and positional accuracy, so it requires more stringent image guidance and higher precision than traditional X‐ray therapy. Objective This study evaluates radiation doses from CBCT systems (TrueBeam, Halcyon, ProBeam, TOMO) in both adult and pediatric phantoms, measuring dose variations and predicting secondary tumor risks using a radiobiological model. Methods Absorbed doses in organs of adult and pediatric phantoms were measured with OSLDs across imaging systems. The risk of secondary tumors was estimated using the BEIR VII model. Results Halcyon 2.0 and TOMO's MV‐level imaging systems showed significantly higher doses than KV‐level systems. Pediatric patients received 2–3 times higher doses than adults. In KV‐level imaging, Halcyon 2.0 resulted in the highest lung tissue dose in both age groups (17.464 mGy for pediatric, 9.109 mGy for adult), whereas ProBeam had the lowest (6.844 and 4.073 mGy, respectively). The lifetime attributable risk for lung cancer correlated with the dose, with higher risks in children. Conclusions Higher radiation doses lead to greater secondary tumor risk, with the risk being more pronounced in pediatric patients. Continuous thoracic CBCT can deliver up to 1 Gy in thoracic organs, posing a significant risk of secondary tumors, especially in younger patients. Careful consideration of this risk is essential in treatment planning. |
| format | Article |
| id | doaj-art-4b63172c6cff4e51b63949d2a3206775 |
| institution | Kabale University |
| issn | 1759-7706 1759-7714 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Thoracic Cancer |
| spelling | doaj-art-4b63172c6cff4e51b63949d2a32067752025-08-20T03:29:58ZengWileyThoracic Cancer1759-77061759-77142025-06-011612n/an/a10.1111/1759-7714.70102The Thoracic Absorption Dose and Secondary Tumor Risk Caused by Different Imaging Methods in Image‐Guided Particle RadiotherapyQinghao Cui0Xianrui Yan1Chengqiang Li2Jian Zhu3Jun Ma4Tingting Liu5Linyi Hospital of Traditional Chinese Medicine Department of Radiation Oncology Physics & Technology Linyi ChinaLaboratory of Image Science and Technology, Jiangsu Provincial Joint International Research Laboratory of Medical Information Processing, Centre de Recherche en Information Biomédicale Sino‐français (CRIBs) Southeast University Nanjing People's Republic of ChinaShandong Provincial Key Medical and Health Laboratory of Pediatric Cancer Precision Radiotherapy Shandong Cancer Hospital Jinan ChinaShandong Provincial Key Medical and Health Laboratory of Pediatric Cancer Precision Radiotherapy Shandong Cancer Hospital Jinan ChinaCancer Hospital of Shandong First Medical University Jinan ChinaSun Yat‐Sen University Cancer Center Gansu Hospital Lanzhou ChinaABSTRACT Background Image‐guided radiation therapy uses imaging methods such as CBCT to effectively improve treatment precision. Kilovoltage‐imaging technology provides high soft tissue contrast at low doses, whereas megavoltage‐imaging technology better displays deep and bony structures at high doses. Proton therapy is more sensitive to tissue density and positional accuracy, so it requires more stringent image guidance and higher precision than traditional X‐ray therapy. Objective This study evaluates radiation doses from CBCT systems (TrueBeam, Halcyon, ProBeam, TOMO) in both adult and pediatric phantoms, measuring dose variations and predicting secondary tumor risks using a radiobiological model. Methods Absorbed doses in organs of adult and pediatric phantoms were measured with OSLDs across imaging systems. The risk of secondary tumors was estimated using the BEIR VII model. Results Halcyon 2.0 and TOMO's MV‐level imaging systems showed significantly higher doses than KV‐level systems. Pediatric patients received 2–3 times higher doses than adults. In KV‐level imaging, Halcyon 2.0 resulted in the highest lung tissue dose in both age groups (17.464 mGy for pediatric, 9.109 mGy for adult), whereas ProBeam had the lowest (6.844 and 4.073 mGy, respectively). The lifetime attributable risk for lung cancer correlated with the dose, with higher risks in children. Conclusions Higher radiation doses lead to greater secondary tumor risk, with the risk being more pronounced in pediatric patients. Continuous thoracic CBCT can deliver up to 1 Gy in thoracic organs, posing a significant risk of secondary tumors, especially in younger patients. Careful consideration of this risk is essential in treatment planning.https://doi.org/10.1111/1759-7714.70102CBCTLAROSLDparticle radiotherapythoracic dose |
| spellingShingle | Qinghao Cui Xianrui Yan Chengqiang Li Jian Zhu Jun Ma Tingting Liu The Thoracic Absorption Dose and Secondary Tumor Risk Caused by Different Imaging Methods in Image‐Guided Particle Radiotherapy Thoracic Cancer CBCT LAR OSLD particle radiotherapy thoracic dose |
| title | The Thoracic Absorption Dose and Secondary Tumor Risk Caused by Different Imaging Methods in Image‐Guided Particle Radiotherapy |
| title_full | The Thoracic Absorption Dose and Secondary Tumor Risk Caused by Different Imaging Methods in Image‐Guided Particle Radiotherapy |
| title_fullStr | The Thoracic Absorption Dose and Secondary Tumor Risk Caused by Different Imaging Methods in Image‐Guided Particle Radiotherapy |
| title_full_unstemmed | The Thoracic Absorption Dose and Secondary Tumor Risk Caused by Different Imaging Methods in Image‐Guided Particle Radiotherapy |
| title_short | The Thoracic Absorption Dose and Secondary Tumor Risk Caused by Different Imaging Methods in Image‐Guided Particle Radiotherapy |
| title_sort | thoracic absorption dose and secondary tumor risk caused by different imaging methods in image guided particle radiotherapy |
| topic | CBCT LAR OSLD particle radiotherapy thoracic dose |
| url | https://doi.org/10.1111/1759-7714.70102 |
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