A feasibility study evaluating the relationship between dose and focal liver reaction in stereotactic ablative radiotherapy for liver cancer based on intensity change of Gd-EOB-DTPA-enhanced magnetic resonance images
Radiation Oncology Journal 2016³â 34±Ç 1È£ p.64 ~ p.75
Á¤»óÈÆ(Jung Sang-Hoon) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiation Oncology
À¯Á¤ÀÏ(Yu Jeong-Il) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiation Oncology
¹ÚÈñö(Park Hee-Chul) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiation Oncology
ÀÓµµÈÆ(Lim Do-Hoon) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiation Oncology
ÇÑ¿µÀÌ(Han Young-Yih) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiation Oncology
Abstract
Purpose: In order to evaluate the relationship between the dose to the liver parenchyma and focal liver reaction (FLR) after stereotactic ablative body radiotherapy (SABR), we suggest a novel method using a three-dimensional dose distribution and change in signal intensity of gadoxetate disodium-gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) hepatobiliary phase images.
Materials and Methods: In our method, change of the signal intensity between the pretreatment and follow-up hepatobiliary phase images of Gd-EOB-DTPA-enhanced MRI was calculated and then threshold dose (TD) for developing FLR was obtained from correlation of dose with the change of the signal intensity. For validation of the method, TDs for six patients, who had been treated for liver cancer with SABR with 45?60 Gy in 3 fractions, were calculated using the method, and we evaluated concordance between volume enclosed by isodose of TD by the method and volume identified as FLR by a physician.
Results: The dose to normal liver was correlated with change in signal intensity between pretreatment and follow-up MRI with a median R2 of 0.935 (range, 0.748 to 0.985). The median TD by the method was 23.5 Gy (range, 18.3 to 39.4 Gy). The median value of concordance was 84.5% (range, 44.7% to 95.9%).
Conclusion: Our method is capable of providing a quantitative evaluation of the relationship between dose and intensity changes on follow-up MRI, as well as determining individual TD for developing FLR. We expect our method to provide better information about the individual relationship between dose and FLR in radiotherapy for liver cancer.
Å°¿öµå
Liver neoplasms, Stereotactic body radiotherapy, Radiation effects, Magnetic resonance imaging, Gadolinium DTPA, Computer assisted image analysis
KMID :
1038620160340010064
¿ø¹® ¹× ¸µÅ©¾Æ¿ô Á¤º¸
µîÀçÀú³Î Á¤º¸
À¯È¿¼º°á°ú(Recomendation)
This study identified the relationship between dose and the change in intensity in follow-up Gd-EOB-DTPA-enhanced MRI hepatobiliary phase images and helps determine individual TDs for developing FLR automatically.