{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T10:29:52Z","timestamp":1779186592565,"version":"3.51.4"},"reference-count":51,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,6,8]],"date-time":"2025-06-08T00:00:00Z","timestamp":1749340800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Multi\u2010isocentric intensity\u2010modulated (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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study answers the question by introducing a new whole\u2010body blood circulation modeling technique.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A whole\u2010body 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\u2010learning\u2010based auto\u2010contouring software. The main blood vessels were segmented using an in\u2010house algorithm. Blood density, velocity, time\u2010to\u2010heart, 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\u00a0Gy in 8 fractions, doses to circulating blood were calculated for three plans: (1) an IM\u2010TBI 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\u2010target tissue.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Circulating blood received 1.57\u00a0\u00b1\u00a00.43\u00a0Gy, 1.04\u00a0\u00b1\u00a00.32\u00a0Gy, and 1.09\u00a0\u00b1\u00a00.32\u00a0Gy in one fraction and 12.60\u00a0\u00b1\u00a01.21\u00a0Gy, 8.34\u00a0\u00b1\u00a00.88\u00a0Gy, and 8.71\u00a0\u00b1\u00a00.92\u00a0Gy in 8 fractions in IM\u2010TBI, 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A novel whole\u2010body blood circulating model was developed based on patient\u2010specific anatomy and realistic blood dynamics, concentration, and perfusion. Using the blood circulation model, we developed a dosimetry tool for circulating blood in IM\u2010TBI, TMI, and TMLI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mp.17913","type":"journal-article","created":{"date-parts":[[2025,6,8]],"date-time":"2025-06-08T10:04:13Z","timestamp":1749377053000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Dose to circulating blood in intensity\u2010modulated total body irradiation, total marrow irradiation, and total marrow and lymphoid irradiation"],"prefix":"10.1002","volume":"52","author":[{"given":"Bingqi","family":"Guo","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheen","family":"Cherian","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Cleveland Clinic  Cleveland Ohio 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