title: Changes in radiation dose with variations in human anatomy: moderately and severely obese adults.
abstract: The phantoms used in standardized dose assessment are based on a median (i.e., 50th percentile) individual of a large population, for example, adult males or females or children of a particular age. Here we describe phantoms that model instead the influence of obesity on specific absorbed fractions (SAFs) and dose factors in adults.
  
  
  METHODS
  The literature was reviewed to evaluate how individual organ sizes change with variations in body weight in mildly and severely obese adult men and women. On the basis of the literature evaluation, changes were made to our deformable reference adult male and female total-body models. Monte Carlo simulations of radiation transport were performed. SAFs for photons were generated for mildly and severely obese adults, and comparisons were made to the reference (50th) percentile SAF values.
  
  
  RESULTS
  SAFs studied between the obese phantoms and the 50th percentile reference phantoms were not significantly different from the reference 50th percentile individual, with the exception of intestines irradiating some abdominal organs, because of an increase in separation between folds caused by an increase in mesenteric adipose deposits. Some low-energy values for certain organ pairs were different, possibly due only to the statistical variability of the data at these low energies.
  
  
  CONCLUSIONS
  The effect of obesity on dose calculations for internal emitters is minor and may be neglected in the routine use of standardized dose estimates.
authors.affiliation: Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN 37232-2675, USA.
authors.forename: Landon D
authors.initials: LD
authors.lastname: Clark
authors.forename: Michael G
authors.initials: MG
authors.lastname: Stabin
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Fernald
authors.forename: Aaron B
authors.initials: AB
authors.lastname: Brill
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008953:Models, Anatomic; D009765:Obesity / Q000473:pathology*; D009929:Organ Size; D019047:Phantoms, Imaging; D011829:Radiation Dosage; D035501:Uncertainty