{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T23:59:00Z","timestamp":1775951940155,"version":"3.50.1"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,3,21]],"date-time":"2013-03-21T00:00:00Z","timestamp":1363824000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":894,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aip.org"],"crossmark-restriction":true},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2013,4]]},"abstract":"<jats:sec><jats:title><jats:bold>Purpose:<\/jats:bold><\/jats:title><jats:p>Total body irradiation (TBI) has been used for bone marrow transplant for hematologic and immune deficiency conditions. The goal of TBI is to deliver a homogeneous dose to the entire body, with a generally accepted range of dose uniformity being within \u00b110% of the prescribed dose. The moving table technique for TBI could make dose uniform in whole body by adjusting couch speed. However, it is difficult to accurately estimate the actual dose by calculation and hence<jats:italic>in vivo<\/jats:italic> dosimetry (IVD) is routinely performed. Here, the authors present patterns of patient\u2010specific IVD in 161 TBI patients treated at our institution.<\/jats:p><\/jats:sec><jats:sec><jats:title><jats:bold>Methods:<\/jats:bold><\/jats:title><jats:p>Cobalt\u201060 teletherapy unit (Model C9 Cobalt\u201060 teletherapy unit, Picker X\u2010ray Corporation) with customized moving bed (SITI Industrial Products, Inc., Fishers, IN) were used for TBI treatment. During treatment, OneDose<jats:sup>TM<\/jats:sup> (Sicel Technology, NC) Metal Oxide\u2010silicon Semiconductor Field Effect Transistor detectors were placed at patient body surface; both entrance and exit side of the beam at patient head, neck, mediastinum, umbilicus, and knee to estimate midplane dose. When large differences (&gt;10%) between the prescribed and measured dose were observed, dose delivery was corrected for subsequent fractions by the adjustment of couch speed and\/or bolus placement. Under IRB exempt status, the authors retrospectively analyzed the treatment records of 161 patients who received TBI treatment between 2006 and 2011.<\/jats:p><\/jats:sec><jats:sec><jats:title><jats:bold>Results:<\/jats:bold><\/jats:title><jats:p>Across the entire cohort, the median \u00b1 SD (range) percent variance between calculated and measured dose for head, neck, mediastinum, umbilicus, and knee was \u22122.3 \u00b1 10.2% (\u221266.2 to +35.3), 1.1 \u00b1 11.5% (\u221262.2 to +40.3), \u22121.9 \u00b1 9.5% (\u221266.4 to +46.6), \u22121.1 \u00b1 7.2% (\u221235.2 to +42.9), and 3.4 \u00b1 12.2% (\u221247.9 to +108.5), respectively. More than half of treatments were within \u00b110% of the prescribed dose for all anatomical regions. For 80% of treatments (10%\u201390%), dose at the umbilicus was within \u00b110%. However, some large differences greater than 35% were also found at several points. For one case, the knee received double the prescribed dose. When the dose differences for multiple fractions were averaged, compliance (\u00b110%) between the prescription and measured dose was improved compared to the dose difference of the first single fraction, for example, as at umbilicus, which improved from 83.9% to 98.5%.<\/jats:p><\/jats:sec><jats:sec><jats:title><jats:bold>Conclusions:<\/jats:bold><\/jats:title><jats:p>Actual dose measurement analysis of TBI patients revealed a potentially wide variance from the calculated dose. Based from their IVD method for TBI using Cobalt\u201060 irradiator and moving table, \u00b110% over entire body is hard to achieve. However, it can be significantly improved with immediate feedback after the first fraction prior to subsequent treatments.<\/jats:p><\/jats:sec>","DOI":"10.1118\/1.4795335","type":"journal-article","created":{"date-parts":[[2013,3,21]],"date-time":"2013-03-21T22:03:14Z","timestamp":1363903394000},"update-policy":"https:\/\/doi.org\/10.1063\/aip-crossmark-policy-page","source":"Crossref","is-referenced-by-count":14,"title":["Patterns of patient specific dosimetry in total body irradiation"],"prefix":"10.1002","volume":"40","author":[{"given":"Yuichi","family":"Akino","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin P.","family":"McMullen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Indra J.","family":"Das","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,3,21]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM195709122571102"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0360\u20103016(97)00578\u20106"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s000660050048"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.4103\/0971\u20106203.25664"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.09.117"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2008.327"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0360\u20103016(97)00913\u20109"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0167\u20108140(85)80122\u20105"},{"key":"e_1_2_7_10_1","doi-asserted-by":"crossref","DOI":"10.37206\/16","volume-title":"The physical aspects of total and half body photon irradiation: A Report of Task Group 29, Radiation Therapy Committee, American Association of Physicists in Medicine","author":"Dyk J. 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