Implementation of MLC-based techniques for kidney protection as isolated organs during radiotherapy of abdominal malignancies

Introduction:  Radiotherapy is one of the therapeutic options for malignancies associated with the abdominal cavity. However, the delivered dose must be limited to the kidneys' custom shielding blocks. This study aimed to propose a method in which kidney shielding blocks can be replaced with mu...

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Main Authors: Warya Parvaii, Ghazal Mehri-Kakavand, Tahereh Hadisinia
Format: Article
Language:fas
Published: Ilam University of Medical Sciences 2025-05-01
Series:Majallah-i Dānishgāh-i ’Ulūm-i Pizishkī-i Īlām
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Online Access:http://sjimu.medilam.ac.ir/article-1-8569-en.pdf
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author Warya Parvaii
Ghazal Mehri-Kakavand
Tahereh Hadisinia
author_facet Warya Parvaii
Ghazal Mehri-Kakavand
Tahereh Hadisinia
author_sort Warya Parvaii
collection DOAJ
description Introduction:  Radiotherapy is one of the therapeutic options for malignancies associated with the abdominal cavity. However, the delivered dose must be limited to the kidneys' custom shielding blocks. This study aimed to propose a method in which kidney shielding blocks can be replaced with multi-leaf collimators (MLCs). Materials & Methods: In the initial phase, both kidneys were protected, and the open field area was irradiated. However, the region between each kidney and the lateral abdominal wall was inevitably shielded. Therefore, in subsequent phases, the dose to the shielded region was necessarily compensated. This process was analyzed by treatment planning and Kodak EDR2 film dosimetry. The dosimetric film results, read with MATLAB, were compared with TPS data, showing a mean difference of less than 5%, indicating acceptable agreement between the two methods. Results: The MLC-based shielding method demonstrated a noticeable reduction in treatment time compared to the time required for custom block fabrication and patient setup. The use of MLCs resulted in only a 3.86% increase in MU, which was not clinically significant. The mean dose to both kidneys in the MLC and cerrobend block methods remained within the renal tolerance limits. Furthermore, the consistency of average V10, V15, and V20 data for the left and right kidneys supported the agreement between the cerrobend block and MLC methods. Conclusion: MLC application to the island organ as a shield is suggested, especially in AP/PA WAR. But sufficient accuracy in field matching is needed.
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publisher Ilam University of Medical Sciences
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spelling doaj-art-8a66ea3cfd1f4edf8893bfa81e27738e2025-08-25T07:35:08ZfasIlam University of Medical SciencesMajallah-i Dānishgāh-i ’Ulūm-i Pizishkī-i Īlām1563-47282588-31352025-05-01332112Implementation of MLC-based techniques for kidney protection as isolated organs during radiotherapy of abdominal malignanciesWarya Parvaii0Ghazal Mehri-Kakavand1Tahereh Hadisinia2 Medical Physics Dept, Ilam University of Medical Science, Ilam, Iran Dept of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand Radiology Dept, School of Paramedical sciences, Guilan University of Medical Sciences, Rasht, Iran Introduction:  Radiotherapy is one of the therapeutic options for malignancies associated with the abdominal cavity. However, the delivered dose must be limited to the kidneys' custom shielding blocks. This study aimed to propose a method in which kidney shielding blocks can be replaced with multi-leaf collimators (MLCs). Materials & Methods: In the initial phase, both kidneys were protected, and the open field area was irradiated. However, the region between each kidney and the lateral abdominal wall was inevitably shielded. Therefore, in subsequent phases, the dose to the shielded region was necessarily compensated. This process was analyzed by treatment planning and Kodak EDR2 film dosimetry. The dosimetric film results, read with MATLAB, were compared with TPS data, showing a mean difference of less than 5%, indicating acceptable agreement between the two methods. Results: The MLC-based shielding method demonstrated a noticeable reduction in treatment time compared to the time required for custom block fabrication and patient setup. The use of MLCs resulted in only a 3.86% increase in MU, which was not clinically significant. The mean dose to both kidneys in the MLC and cerrobend block methods remained within the renal tolerance limits. Furthermore, the consistency of average V10, V15, and V20 data for the left and right kidneys supported the agreement between the cerrobend block and MLC methods. Conclusion: MLC application to the island organ as a shield is suggested, especially in AP/PA WAR. But sufficient accuracy in field matching is needed.http://sjimu.medilam.ac.ir/article-1-8569-en.pdfmlccerrobend blockwarkidneydosimetry
spellingShingle Warya Parvaii
Ghazal Mehri-Kakavand
Tahereh Hadisinia
Implementation of MLC-based techniques for kidney protection as isolated organs during radiotherapy of abdominal malignancies
Majallah-i Dānishgāh-i ’Ulūm-i Pizishkī-i Īlām
mlc
cerrobend block
war
kidney
dosimetry
title Implementation of MLC-based techniques for kidney protection as isolated organs during radiotherapy of abdominal malignancies
title_full Implementation of MLC-based techniques for kidney protection as isolated organs during radiotherapy of abdominal malignancies
title_fullStr Implementation of MLC-based techniques for kidney protection as isolated organs during radiotherapy of abdominal malignancies
title_full_unstemmed Implementation of MLC-based techniques for kidney protection as isolated organs during radiotherapy of abdominal malignancies
title_short Implementation of MLC-based techniques for kidney protection as isolated organs during radiotherapy of abdominal malignancies
title_sort implementation of mlc based techniques for kidney protection as isolated organs during radiotherapy of abdominal malignancies
topic mlc
cerrobend block
war
kidney
dosimetry
url http://sjimu.medilam.ac.ir/article-1-8569-en.pdf
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AT ghazalmehrikakavand implementationofmlcbasedtechniquesforkidneyprotectionasisolatedorgansduringradiotherapyofabdominalmalignancies
AT taherehhadisinia implementationofmlcbasedtechniquesforkidneyprotectionasisolatedorgansduringradiotherapyofabdominalmalignancies