{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:34:03Z","timestamp":1777941243801,"version":"3.51.4"},"reference-count":27,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Shenzhen High-level Hospital Construction Fund"},{"DOI":"10.13039\/501100012151","name":"Sanming Project of Medicine in Shenzen Municipality","doi-asserted-by":"publisher","award":["SZSM202211030"],"award-info":[{"award-number":["SZSM202211030"]}],"id":[{"id":"10.13039\/501100012151","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Hospital Research Project","award":["E010322001"],"award-info":[{"award-number":["E010322001"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["12105367"],"award-info":[{"award-number":["12105367"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Shenzhen Key Medical Discipline Construction Fund","award":["SZXK013"],"award-info":[{"award-number":["SZXK013"]}]},{"name":"Shenzhen Science and Technology Program","award":["JCYJ20220530153803008"],"award-info":[{"award-number":["JCYJ20220530153803008"]}]},{"name":"Shenzhen Science and Technology Program","award":["JCYJ20240813151606009"],"award-info":[{"award-number":["JCYJ20240813151606009"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Technol Cancer Res Treat"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>This retrospective study evaluated the imaging dose of 4D-CBCT in patients treated with thoracic radiotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A geometric model of a 4D-CBCT system was built for Monte Carlo (MC) calculations. Percentage depth dose (PDD) and profiles of the system were measured and compared with MC calculations to verify the model. Eight lung cancer patients were retrospectively selected for 4D-CBCT imaging dose assessment. For each patient, the imaging dose was calculated using the CBCT log file, simulating CT and the MC model. Organ at risk (OAR) dose parameters from the imaging dose were calculated, and the effect of the imaging dose on OAR dose parameters when the imaging dose was added to the treatment dose was analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Deviations between MC calculations and measurements for PDD and profiles were within 1.1% and 5%, respectively. For a pre-treatment 4D-CBCT scan, the mean lung and heart doses were 9.5\u2009\u00b1\u20091.4\u2005mGy (mean value\u2009\u00b1\u2009standard deviation, hereafter the same) and 9.7\u2009\u00b1\u20091.4\u2005mGy, and the maximum spinal cord, esophagus and ribs doses were 17.6\u2009\u00b1\u20094.2\u2005mGy, 17.1\u2009\u00b1\u20093.3\u2005mGy and 37.8\u2009\u00b1\u20095.3\u2005mGy, respectively. For an in-treatment 4D-CBCT scan, the dose parameters were 5.6\u2009\u00b1\u20091.8\u2005mGy, 5.6\u2009\u00b1\u20091.5\u2005mGy, 10.3\u2009\u00b1\u20093.5\u2005mGy, 10.3\u2009\u00b1\u20094.3\u2005mGy and 22.4\u2009\u00b1\u20095.3\u2005mGy, respectively. The OAR dose parameters for in-treatment 4D-CBCT scans showed a relatively strong linear relationship with beam MU and number of frames. For patients receiving 5-fraction treatments and one pre-treatment and one in-treatment 4D-CBCT for each fraction, the increases in lung V20, lung V5, mean lung and heart doses, maximum spinal cord, esophagus and ribs doses were 0.04\u2009\u00b1\u20090.03%, 0.29\u2009\u00b1\u20090.23%, 76.3\u2009\u00b1\u200914.4\u2005mGy, 76.5\u2009\u00b1\u200912.0\u2005mGy, 76.3\u2009\u00b1\u200920.2\u2005mGy, 70.5\u2009\u00b1\u200913.1\u2005mGy and 101.2\u2009\u00b1\u200920.5\u2005mGy, respectively. The increase in OAR dose parameters was proportional to the number of fractions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The imaging dose of pre-treatment and in-treatment 4D-CBCT was calculated using a validated MC model. For 5-fraction treatments, the imaging dose will likely have minimal clinical impact on OAR dose parameters.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15330338251366729","type":"journal-article","created":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T06:42:51Z","timestamp":1754548971000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of Concomitant Imaging Dose in 4D-CBCT Guided Thoracic Radiotherapy"],"prefix":"10.1177","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3207-965X","authenticated-orcid":false,"given":"Wu","family":"Jianan","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital &amp; Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sang","family":"Yong","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital &amp; Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Zhangmin","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Guangzhou Concord Cancer Hospital, Guangzhou, People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liang","family":"Ying","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital &amp; Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2124-7635","authenticated-orcid":false,"given":"Zhao","family":"Man","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital &amp; Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hu","family":"Yuchao","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital &amp; Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jia","family":"Yajun","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital &amp; Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,8,6]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00233-6"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/mp.12824"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.12755"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2008.08.004"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1088\/1361-6560\/ac55a4"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmp.2015.06.003"},{"issue":"9","key":"e_1_3_3_9_2","first-page":"4156","article-title":"Monte Carlo simulation and patient dosimetry for a kilovoltage cone-beam CT unit","volume":"36","author":"Downes P","unstructured":"Downes P, Jarvis R, Radu E, Kawrakow I, Spezi E. Monte Carlo simulation and patient dosimetry for a kilovoltage cone-beam CT unit. Med Phys. 2009 Sep;36(9):4156-4167. doi: https:\/\/doi.org\/10.1118\/1.3196182","journal-title":"Med Phys"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1118\/1.3031113"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1088\/0031-9155\/61\/15\/5781"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.3109\/0284186X.2013.875626"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2015.06.034"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/jrr\/rrx098"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.12741"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1120\/jacmp.v17i6.6459"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-147-8-200710160-00010"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1118\/1.4758060"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-9002(03)01368-8"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1109\/TNS.2006.869826"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nima.2016.06.125"},{"issue":"12","key":"e_1_3_3_22_2","first-page":"2605","article-title":"The IPEMB code of practice for the determination of absorbed dose for x-rays below 300kV generating potential (0.035mm Al-4mm Cu HVL; 10-300kV generating potential)","volume":"41","author":"Klevenhagen SC","unstructured":"Klevenhagen SC, Aukett RJ, Harrison RM, Moretti C, Nahum AE, Rosser KE. The IPEMB code of practice for the determination of absorbed dose for x-rays below 300kV generating potential (0.035mm Al-4mm Cu HVL; 10-300kV generating potential). Institution of Physics and Engineering in Medicine and Biology. Phys Med Biol. 1996 Dec;41(12):2605-2625. doi: https:\/\/doi.org\/10.1088\/0031-9155\/41\/12\/002","journal-title":"Institution of Physics and Engineering in Medicine and Biology. Phys Med Biol"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.14531"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1088\/1361-6560\/ab3b94"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1088\/0031-9155\/45\/2\/314"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1118\/1.2825619"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1088\/0031-9155\/58\/16\/5693"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1118\/1.3271582"}],"container-title":["Technology in Cancer Research &amp; Treatment"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15330338251366729","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15330338251366729","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15330338251366729","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T06:16:57Z","timestamp":1777702617000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15330338251366729"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6]]},"references-count":27,"alternative-id":["10.1177\/15330338251366729"],"URL":"https:\/\/doi.org\/10.1177\/15330338251366729","relation":{},"ISSN":["1533-0346","1533-0338"],"issn-type":[{"value":"1533-0346","type":"print"},{"value":"1533-0338","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6]]},"article-number":"15330338251366729"}}