{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T19:31:42Z","timestamp":1769801502236,"version":"3.49.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,28]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>This study aimed to establish the diagnostic reference levels (DRLs) of imaging doses for image-guided radiotherapy (IGRT) used in intensity-modulated radiotherapy for prostate cancer in Japan. A nationwide survey was conducted to gather data on image acquisition conditions, parameters, and frequencies across 193 radiation therapy institutions using intensity-modulated radiotherapy. IGRT modalities, such as kilovoltage and megavoltage cone-beam computed tomography (CBCT), two-dimensional imaging, and in-room computed tomography (CT), were targeted. Data analysis focused on image acquisition parameters displayed by the devices, such as tube voltage, current, and imaging dose, along with the CT dose index volume (CTDIvol) and dose-length product (DLP), were collected from 222 radiotherapy devices. The results showed that kV-CT\/CBCT was the most frequently used modality, used in 94% of the institutions. Imaging dose-reduction techniques were adopted by over half of the institutions, with 56% optimizing imaging parameters and 45% reducing the imaging field size or scan length. The 75th percentile for CTDIvol was 16.0\u00a0mGy, while that for DLP was 263\u00a0mGy\u00b7cm, with considerable variation among devices and institutions. This study provides the first large-scale reference data for IGRT imaging doses used for prostate cancer treatment in Japan. These results are critical for improving patient safety by optimizing imaging protocols and establishing DRLs tailored to IGRT. These findings will serve as a basis for further refinement of radiological protection practices in Japan.<\/jats:p>","DOI":"10.1093\/jrr\/rraf080","type":"journal-article","created":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T12:35:06Z","timestamp":1762778106000},"page":"95-103","source":"Crossref","is-referenced-by-count":0,"title":["Imaging dose in image-guided radiotherapy for localized prostate intensity-modulated radiotherapy: a nationwide survey in Japan"],"prefix":"10.1093","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8360-5544","authenticated-orcid":false,"given":"Satoshi","family":"Kito","sequence":"first","affiliation":[{"name":"Division of Radiation Oncology, Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital , 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677 \u00a0","place":["Japan"]},{"name":"Department of Radiology, Tokyo Metropolitan Bokutoh Hospital , 4-23-15 Kotobashi, Sumida-ku 130-8575 \u00a0","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Takizawa","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Niigata Neurosurgical Hospital , 3057 Yamada, Nishi-ku 950-1101 \u00a0","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3488-3871","authenticated-orcid":false,"given":"Satoshi","family":"Tanabe","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Niigata University Medical and Dental Hospital , 1-757 Asahimachi-dori, Chuo-ku 951-8510 \u00a0","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuhi","family":"Suda","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology, Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital , 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677 \u00a0","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomomasa","family":"Nagahata","sequence":"additional","affiliation":[{"name":"Radiological Division in Osaka Metropolitan University Hospital , 1-5-7 Asahi-chou, Osaka 545-8586 \u00a0","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoki","family":"Tohyama","sequence":"additional","affiliation":[{"name":"Department of Radiation Sciences, Komazawa University , 1-23-1 Komazawa, Setagaya, Tokyo 154-8525 \u00a0","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9491-787X","authenticated-orcid":false,"given":"Hiroyuki","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Radiation Safety and Quality Assurance Division, National Cancer Center Hospital , 5-1-1 Tsukiji, Chuo-ku 104-0045 \u00a0","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takumi","family":"Kodama","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Saitama Cancer Center , 780, Ooazakomuro, Ina 362-0806 \u00a0","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukio","family":"Fujita","sequence":"additional","affiliation":[{"name":"Department of Radiation Sciences, Komazawa University , 1-23-1 Komazawa, Setagaya, Tokyo 154-8525 \u00a0","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hisayuki","family":"Miyashita","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, St. Marianna University Hospital , 2-16-1, Sugao, Miyamae-ku, Kawasaki-City, Kanagawa 216-8511 \u00a0","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8491-9799","authenticated-orcid":false,"given":"Kazuya","family":"Shinoda","sequence":"additional","affiliation":[{"name":"Department of Radiation Therapy, Ibaraki Prefectural Central Hospital , 6528 Koibuchi, Kasama City, Ibaraki 309-1793 \u00a0","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiko","family":"Kurooka","sequence":"additional","affiliation":[{"name":"Department of Radiation Therapy, Tokyo Medical University Hospital , 6-7-1 Nishishinjuku, Shinjuku-ku 160-0023 \u00a0","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6633-0964","authenticated-orcid":false,"given":"Hidetoshi","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Division of Medical Physics, School of Medical Sciences, Fujita Health University , 1-98, Dengakugakubo, 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