{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T16:35:00Z","timestamp":1754152500779,"version":"3.41.2"},"reference-count":19,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T00:00:00Z","timestamp":1750032000000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004775","name":"Natural Science Foundation of Gansu Province","doi-asserted-by":"publisher","award":["24JRRA1152"],"award-info":[{"award-number":["24JRRA1152"]}],"id":[{"id":"10.13039\/501100004775","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100018537","name":"National Science and Technology Major Project","doi-asserted-by":"publisher","award":["2024ZD0519901"],"award-info":[{"award-number":["2024ZD0519901"]}],"id":[{"id":"10.13039\/501100018537","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82172072"],"award-info":[{"award-number":["82172072"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014103","name":"Key Technology Research and Development Program of Shandong Province","doi-asserted-by":"publisher","award":["2024CXPT084"],"award-info":[{"award-number":["2024CXPT084"]}],"id":[{"id":"10.13039\/100014103","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007129","name":"Natural Science Foundation of Shandong Province","doi-asserted-by":"publisher","award":["ZR2022QH188"],"award-info":[{"award-number":["ZR2022QH188"]}],"id":[{"id":"10.13039\/501100007129","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Thoracic Cancer"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Image\u2010guided radiation therapy uses imaging methods such as CBCT to effectively improve treatment precision. Kilovoltage\u2010imaging technology provides high soft tissue contrast at low doses, whereas megavoltage\u2010imaging 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\u2010ray therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Halcyon 2.0 and TOMO's MV\u2010level imaging systems showed significantly higher doses than KV\u2010level systems. Pediatric patients received 2\u20133 times higher doses than adults. In KV\u2010level imaging, Halcyon 2.0 resulted in the highest lung tissue dose in both age groups (17.464\u2009mGy for pediatric, 9.109\u2009mGy for adult), whereas ProBeam had the lowest (6.844 and 4.073\u2009mGy, respectively). The lifetime attributable risk for lung cancer correlated with the dose, with higher risks in children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>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\u2009Gy in thoracic organs, posing a significant risk of secondary tumors, especially in younger patients. Careful consideration of this risk is essential in treatment planning.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1759-7714.70102","type":"journal-article","created":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T01:11:38Z","timestamp":1750122698000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Thoracic Absorption Dose and Secondary Tumor Risk Caused by Different Imaging Methods in Image\u2010Guided Particle Radiotherapy"],"prefix":"10.1111","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8562-5140","authenticated-orcid":false,"given":"Qinghao","family":"Cui","sequence":"first","affiliation":[{"name":"Linyi Hospital of Traditional Chinese Medicine Department of Radiation Oncology Physics &amp; Technology  Linyi China"},{"name":"Department of Engineering Physics Tsinghua University  Beijing China"},{"name":"Shandong Provincial Key Medical and Health Laboratory of Pediatric Cancer Precision Radiotherapy Shandong Cancer Hospital  Jinan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xianrui","family":"Yan","sequence":"additional","affiliation":[{"name":"Laboratory of Image Science and Technology, Jiangsu Provincial Joint International Research Laboratory of Medical Information Processing, Centre de Recherche en Information Biom\u00e9dicale Sino\u2010fran\u00e7ais (CRIBs) Southeast University  Nanjing People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chengqiang","family":"Li","sequence":"additional","affiliation":[{"name":"Shandong Provincial Key Medical and Health Laboratory of Pediatric Cancer Precision Radiotherapy Shandong Cancer Hospital  Jinan China"},{"name":"Department of Radiation Oncology Physics &amp; Technology Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences  Jinan China"},{"name":"Cancer Hospital of Shandong First Medical University  Jinan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian","family":"Zhu","sequence":"additional","affiliation":[{"name":"Shandong Provincial Key Medical and Health Laboratory of Pediatric Cancer Precision Radiotherapy Shandong Cancer Hospital  Jinan China"},{"name":"Department of Radiation Oncology Physics &amp; Technology Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences  Jinan China"},{"name":"Cancer Hospital of Shandong First Medical University  Jinan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Ma","sequence":"additional","affiliation":[{"name":"Cancer Hospital of Shandong First Medical University  Jinan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tingting","family":"Liu","sequence":"additional","affiliation":[{"name":"Sun Yat\u2010Sen University Cancer Center Gansu Hospital  Lanzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,6,16]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/9696403"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(19)30339-0"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.13164"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.COT.0001011472.43689.c0"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2020.611514"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.37549\/ARO1013"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apradiso.2022.110199"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1109\/TNS.2013.2258175"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2007.10.014"},{"key":"e_1_2_10_11_1","unstructured":"J. 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