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Individualized evaluation of the total dose received by radiotherapy patients: Integrating in-field, out-of-field, and imaging doses

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dc.contributor.authorRomero-Expósito, Maite
dc.contributor.authorSánchez-Nieto, Beatriz
dc.contributor.authorRiveira-Martin, Mercedes
dc.contributor.authorAzizi, Mona
dc.contributor.authorGkavonatsiou, Angeliki
dc.contributor.authorMuñoz, Isidora
dc.contributor.authorLópez-Martínez , Ignacio N.
dc.contributor.authorEspinoza, Ignacio
dc.contributor.authorZelada, Gabriel
dc.contributor.authorCordova-Bernhardt, Andrés
dc.contributor.authorNorrlid, Ola
dc.contributor.authorGoldkuhl, Christina
dc.contributor.authorMolin, Daniel
dc.contributor.authorMosquera-Pena Sánchez, Francisco
dc.contributor.authorLópez-Medina, Antonio
dc.contributor.authorToma-Dasu, Iuliana
dc.contributor.authorDasu, Alexandru
dc.date.accessioned2026-09-23T16:00:11Z
dc.date.available2026-09-23T16:00:11Z
dc.date.issued2025
dc.description.abstractPurpose: To propose a methodology for integrating the out-of-field and imaging doses to the in-field dose received by radiotherapy (RT) patients. In addition, the impact of considering the total dose in planning and radiation- induced second malignancies (RISM) risk assessment will be evaluated in several scenarios comprising photon and proton treatments. Methods: The total dose is the voxel-wise sum of the doses from the different radiation sources (accounting for the radiobiological effectiveness) produced during the whole RT chain. The dose from the plan and imaging procedures were obtained by measurements for a photon prostate treatment and by calculation (combining treatment planning system, analytical models, and Monte Carlo simulations) for two lymphoma treatments, one using photons and the other, protons. Dose distributions, dose volume histograms (DVHs) metrics, mean organ doses, and RISM risks were evaluated for each radiation exposure in each treatment. Results: In general, the contribution of the imaging doses is low compared to the dose administered during RT treatment, being higher in proton therapy. However, for some organs, for instance testes in the prostate case, the maging dose becomes higher than the scattered dose from the treatment fields. Plan evaluations revealed shifts in cumulative DVHs with the inclusion of out-of-field and imaging doses, though minimal clinical impact is expected. Risk assessment showed increased estimates with total dose. Conclusions: The methodology enables accounting for the total dose for optimization of plans and imaging protocols, prospective risk predictions and retrospective epidemiological analyses.
dc.format.extent14 p.
dc.identifier.citationMaite Romero-Expósito, Beatriz Sánchez-Nieto, Mercedes Riveira-Martin, Mona Azizi, Angeliki Gkavonatsiou, Isidora Muñoz, Ignacio N. López-Martínez, Ignacio Espinoza, Gabriel Zelada, Andrés Córdova-Bernhardt, Ola Norrlid, Christina Goldkuhl, Daniel Molin, Francisco Mosquera-Pena Sánchez, Antonio López-Medina, Iuliana Toma-Dasu, Alexandru Dasu, Individualized evaluation of the total dose received by radiotherapy patients: Integrating in-field, out-of-field, and imaging doses, Physica Medica, Volume 129, 2025, 104879, ISSN 1120-1797, https://doi.org/10.1016/j.ejmp.2024.104879. (https://www.sciencedirect.com/science/article/pii/S1120179724013474)
dc.identifier.doihttps://doi.org/10.1016/j.ejmp.2024.104879
dc.identifier.urihttps://hdl.handle.net/11447/11173
dc.language.isoen
dc.subjectImaging doses
dc.subjectRT out-of-field doses
dc.subjectTotal doses
dc.subjectRisk assessment
dc.titleIndividualized evaluation of the total dose received by radiotherapy patients: Integrating in-field, out-of-field, and imaging doses
dc.typeArticle
dcterms.accessRightsAcceso abierto
dcterms.sourcePhysica Medica
dspace.entity.typePublication

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