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The EGSnrc\/BEAMnrc were used to simulate the on\u2010board imager (OBI) from the TrueBeam linear accelerator. Specifically, the OBI was modeled based on the percent depth dose and the off\u2010center ratio was measured using a three\u2010dimensional (3D) water phantom. For clinical cases, 15 lung and liver cancer patients were simulated using the EGSnrc\/DOSXYZnrc. The mean absorbed doses to the lung, stomach, bone marrow, esophagus, liver, thyroid, bone surface, skin, adrenal glands, gallbladder, heart, intestine, kidney, pancreas and spleen, were quantified using a treatment planning system, and the equivalent doses to each organ were calculated. Subsequently, the effective dose was calculated as the weighted sum of the equivalent dose, and the EAR of the secondary cancer incidence was determined for each organ with the use of the biologic effects of ionizing radiation (BEIR) VII model. The effective doses were 3.9\u00a0\u00b1\u00a00.5, 15.7\u00a0\u00b1\u00a02.0, and 7.3\u00a0\u00b1\u00a00.9\u00a0mSv, for the lung, and 4.2\u00a0\u00b1\u00a00.6, 16.7\u00a0\u00b1\u00a02.4, and 7.8\u00a0\u00b1\u00a01.1\u00a0mSv, for the liver in the respective cases of the 3D\u2010CBCT (thorax, pelvis) and 4D\u2010CBCT modes. The lung EARs for males and females were 7.3 and 10.7 cases per million person\u2010years, whereas the liver EARs were 9.9 and 4.5 cases per million person\u2010years. The EAR increased with increasing time since radiation exposure. In clinical studies, we should use 4D\u2010CBCT based on consideration of the effective dose and EAR of secondary cancer incidence.<\/jats:p>","DOI":"10.1002\/acm2.12741","type":"journal-article","created":{"date-parts":[[2019,10,8]],"date-time":"2019-10-08T14:57:59Z","timestamp":1570546679000},"page":"57-68","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Estimation of effective imaging dose and excess absolute risk of secondary cancer incidence for four\u2010dimensional cone\u2010beam computed tomography acquisition"],"prefix":"10.1002","volume":"20","author":[{"given":"Yuki","family":"Yuasa","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Graduate School of Medicine Yamaguchi University Ube Yamaguchi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takehiro","family":"Shiinoki","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Graduate School of Medicine Yamaguchi University Ube Yamaguchi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryota","family":"Onizuka","sequence":"additional","affiliation":[{"name":"Department of Radiological Technology Yamaguchi University Hospital Ube Yamaguchi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koya","family":"Fujimoto","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Graduate School of Medicine Yamaguchi University Ube Yamaguchi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,10,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.4824056"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2007.07.2352"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.4924268"},{"key":"e_1_2_8_5_1","unstructured":"KeallPJ MagerasGS BalterJM et al.The management of respiratory motion in radiation oncology report of AAPM Task Group 76.2006."},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.1869074"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.4881326"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2016.07.022"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13014-016-0677-8"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1088\/2057-1976\/aa8ade"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00066-015-0929-9"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1120\/jacmp.v15i4.4737"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13014-017-0799-7"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.2775667"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1088\/1361-6560\/aab242"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2016.08.030"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2007.08.062"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/HP.0b013e3181cd3ec3"},{"key":"e_1_2_8_19_1","first-page":"194","article-title":"Imaging dose of human organs from KV\u2010CBCT in image\u2010guided radiation therapy","volume":"175","author":"Son K","year":"2017","journal-title":"Radiat Prot Dosimetry"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmp.2017.10.019"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.598917"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.597552"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1103\/RevModPhys.31.920"},{"key":"e_1_2_8_24_1","unstructured":"HubbelJH SeltzerSM.Tables of X\u2010Ray Mass Attenuation Coefficients and Mass Energy\u2010Absorption Coefficients(version 1.4). 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