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1
Total body irradiation (TBI) is commonly used in conditioning regimens for hematopoietic stem cell transplantation but exposes normal tissues to significant radiation.
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2
Total marrow irradiation (TMI) aims to reduce organ-at-risk doses while maintaining target coverage, representing a more targeted alternative to TBI.
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3
In a study of 30 adult leukemia patients, TMI plans showed a statistically significant reduction in dose to all evaluated organs at risk compared to TBI.
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4
Mean doses to the heart, kidneys, and liver were reduced by approximately 5–6 Gy with TMI, along with improved dose homogeneity and lower planning complexity.
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5
AI-based auto-segmentation facilitated target delineation for TMI, potentially reducing workload, but treatment uncertainties must be managed during clinical implementation.
