A multi-institutional survey on technical variations in total body irradiation in Japan.

IF 1.7 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Radiological Physics and Technology Pub Date : 2025-03-14 DOI:10.1007/s12194-025-00894-2
Masayasu Kitagawa, Ryoichi Notake, Ryuta Nakahara, Shogo Hatanaka, Tatsunori Saho, Kengo Matsuda
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Abstract

This study aimed to survey technical variations in total body irradiation (TBI) across Japan. A web-based questionnaire investigating technical aspects (irradiation method, in vivo dosimetry, organ shielding, and boluses) of TBI was distributed via the authors' acquaintances in each region of Japan using snowball sampling, and 73 institutions responded. The data were collected from January to April 2024. Three institutions used two distinct irradiation methods, yielding 76 reported techniques. The reported irradiation techniques included long source-to-surface distance (SSD) techniques, which involve using a large field and extended distance; helical intensity-modulated radiation therapy (IMRT) using specialized equipment (e.g., TomoTherapy), moving couch techniques, and volumetric modulated arc therapy (VMAT) using a standard C-arm linac, with responses totaling 60 (79%), 10 (13%), 4 (5%), and 2 (3%), respectively. All institutions performing IMRT-based (helical IMRT and VMAT) TBI used computed tomography simulation with the patient in the supine position and utilized a 6 MV photon beam. Conversely, the long SSD technique exhibited significant variation; while 47 institutions treated patients exclusively in the supine position, others reported using the prone and lateral positions. Furthermore, the photon beam energies varied, with 10 MV (41 responses), 6 MV (20 responses), and 4 MV (1 response) reported. Notably, 17 institutions using long SSD techniques did not perform in vivo dosimetry and 32 did not use boluses. The differences in the methods used to shield the organs were also reported. These variations highlight the need for standardization of in vivo dosimetry, dose homogeneity strategies, and organ-shielding in TBI.

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本研究旨在调查日本各地全身辐照(TBI)的技术差异。采用滚雪球抽样法,通过作者在日本各地区的熟人分发了一份基于网络的问卷,调查全身辐照的技术方面(辐照方法、体内剂量测定、器官屏蔽和栓剂),共有 73 家机构做出了回应。数据收集时间为 2024 年 1 月至 4 月。三家机构使用了两种不同的辐照方法,共报告了 76 种辐照技术。报告的照射技术包括长源到表面距离(SSD)技术,即使用大野和延长距离;使用专用设备(如 TomoTherapy)的螺旋调强放射治疗(IMRT)、移动床技术和使用标准 C 臂直列加速器的容积调强弧形治疗(VMAT),回复总数分别为 60(79%)、10(13%)、4(5%)和 2(3%)。所有实施基于 IMRT(螺旋 IMRT 和 VMAT)的 TBI 的机构都使用计算机断层扫描模拟患者仰卧位,并使用 6 MV 光子束。相反,长 SSD 技术则表现出明显的差异;47 家机构完全采用仰卧位治疗患者,其他机构则报告采用俯卧位和侧卧位。此外,光子束的能量也各不相同,据报道有 10 MV(41 例)、6 MV(20 例)和 4 MV(1 例)。值得注意的是,17 家使用长 SSD 技术的机构没有进行体内剂量测定,32 家没有使用栓剂。此外,还报告了屏蔽器官所用方法的差异。这些差异凸显了对创伤性脑损伤的体内剂量测定、剂量均匀性策略和器官屏蔽进行标准化的必要性。
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来源期刊
Radiological Physics and Technology
Radiological Physics and Technology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
3.00
自引率
12.50%
发文量
40
期刊介绍: The purpose of the journal Radiological Physics and Technology is to provide a forum for sharing new knowledge related to research and development in radiological science and technology, including medical physics and radiological technology in diagnostic radiology, nuclear medicine, and radiation therapy among many other radiological disciplines, as well as to contribute to progress and improvement in medical practice and patient health care.
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