{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T10:42:25Z","timestamp":1774608145353,"version":"3.50.1"},"reference-count":8,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2015,3,8]],"date-time":"2015-03-08T00:00:00Z","timestamp":1425772800000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:p>This study compares lung dose distributions for two common techniques of total body photon irradiation (TBI) at extended source\u2010to\u2010surface distance calculated with, and without, tissue density correction (TDC). Lung dose correction factors as a function of lateral thorax separation are approximated for bilateral opposed TBI (supine), similar to those published for anteroposterior\u2013posteroanterior (AP\u2013PA) techniques in AAPM Report 17 (i.e., Task Group 29). 3D treatment plans were created retrospectively for 24 patients treated with bilateral TBI, and for whom CT data had been acquired from the head to the lower leg. These plans included bilateral opposed and AP\u2013PA techniques\u2014each with and without \u2014 TDC, using source\u2010to\u2010axis distance of 377 cm and largest possible field size. On average, bilateral TBI requires 40% more monitor units than AP\u2013PA TBI due to increased separation (26% more for 23 MV). Calculation of midline thorax dose without TDC leads to dose underestimation of 17% on average (standard deviation, 4%) for bilateral 6 MV TBI, and 11% on average (standard deviation, 3%) for 23 MV. Lung dose correction factors (CF) are calculated as the ratio of midlung dose (with TDC) to midline thorax dose (without TDC). Bilateral CF generally increases with patient separation, though with high variability due to individual uniqueness of anatomy. Bilateral CF are 5% (standard deviation, 4%) higher than the same corrections calculated for AP\u2013PA TBI in the 6 MV case, and 4% higher (standard deviation, 2%) for 23 MV. The maximum lung dose is much higher with bilateral TBI (up to 40% higher than prescribed, depending on patient anatomy) due to the absence of arm tissue blocking the anterior chest. Dose calculations for bilateral TBI without TDC are incorrect by up to 24% in the thorax for 6 MV and up to 16% for 23 MV. Bilateral lung CF may be calculated as 1.05 times the values published in Table 6 of AAPM Report 17, though a larger patient pool is necessary to better quantify this trend. Bolus or customized shielding will reduce lung maximum dose in the anterior thorax.<\/jats:p><jats:p>PACS numbers: 87.55.D, 87.55.Dk, 87.55.Ne, 87.56.Bd, 87.57.Qp<\/jats:p>","DOI":"10.1120\/jacmp.v16i2.5293","type":"journal-article","created":{"date-parts":[[2017,2,27]],"date-time":"2017-02-27T23:53:23Z","timestamp":1488239603000},"page":"291-301","source":"Crossref","is-referenced-by-count":20,"title":["TBI lung dose comparisons using bilateral and anteroposterior delivery techniques and tissue density corrections"],"prefix":"10.1002","volume":"16","author":[{"given":"Daniel W.","family":"Bailey","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Northside Hospital Cancer Institute  Atlanta GA"},{"name":"Department of Radiation Medicine Roswell Park Cancer Institute  Buffalo NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iris Z.","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiation Medicine Roswell Park Cancer Institute  Buffalo NY"},{"name":"Department of Physiology and Biophysics State University of New York at Buffalo  Buffalo NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tara","family":"Lakeman","sequence":"additional","affiliation":[{"name":"Department of Physiology and Biophysics State University of New York at Buffalo  Buffalo NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lee D.","family":"Hales","sequence":"additional","affiliation":[{"name":"Department of Radiation Medicine Roswell Park Cancer Institute  Buffalo NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anurag K.","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Radiation Medicine Roswell Park Cancer Institute  Buffalo NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew B.","family":"Podgorsak","sequence":"additional","affiliation":[{"name":"Department of Radiation Medicine Roswell Park Cancer Institute  Buffalo NY"},{"name":"Department of Physiology and Biophysics State University of New York at Buffalo  Buffalo NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,3,8]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2009.06.091"},{"key":"e_1_2_5_3_1","volume-title":"The physical aspects of total and half body photon irradiation: a report of Task Group 29, Radiation Therapy Committee Association of Physicists in Medicine","author":"Van Dyk J","year":"1986"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2006.05.023"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1120\/jacmp.v5i4.1980"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1460396910000221"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/0360-3016(81)90131-0"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.3697526"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1120\/jacmp.v11i3.3213"}],"container-title":["Journal of Applied Clinical Medical Physics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1120%2Fjacmp.v16i2.5293","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1120%2Fjacmp.v16i2.5293","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1120\/jacmp.v16i2.5293","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T19:49:20Z","timestamp":1696621760000},"score":1,"resource":{"primary":{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/10.1120\/jacmp.v16i2.5293"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,3]]},"references-count":8,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2015,3]]}},"alternative-id":["10.1120\/jacmp.v16i2.5293"],"URL":"https:\/\/doi.org\/10.1120\/jacmp.v16i2.5293","archive":["Portico"],"relation":{},"ISSN":["1526-9914","1526-9914"],"issn-type":[{"value":"1526-9914","type":"print"},{"value":"1526-9914","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,3]]}}}