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. 2008 Jan 1;70(1):154-60.
doi: 10.1016/j.ijrobp.2007.05.078. Epub 2007 Sep 12.

Liver function after irradiation based on computed tomographic portal vein perfusion imaging

Yue Cao  1 , Charlie Pan, James M Balter, Joel F Platt, Isaac R Francis, James A Knol, Daniel Normolle, Edgar Ben-Josef, Randall K Ten Haken, Theodore S Lawrence
Affiliations

Liver function after irradiation based on computed tomographic portal vein perfusion imaging

Yue Cao et al. Int J Radiat Oncol Biol Phys. .

Abstract

Purpose: To determine whether individual and regional liver sensitivity to radiation could be assessed by measuring liver perfusion during a course of treatment using dynamic contrast-enhanced computed tomography scanning.

Methods and materials: Patients with intrahepatic cancer undergoing conformal radiotherapy underwent dynamic contrast-enhanced computed tomography (to measure perfusion distribution) and an indocyanine extraction study (to measure liver function) before, during, and 1 month after treatment. We hoped to determine whether the residual functioning liver (i.e., those regions showing portal vein perfusion) could be used to predict overall liver function after irradiation.

Results: Radiation doses from 45 to 84 Gy resulted in undetectable regional portal vein perfusion 1 month after treatment. The volume of each liver with undetectable portal vein perfusion ranged from 0 to 39% and depended both on the patient's sensitivity and on dose distribution. There was a significant correlation between indocyanine green clearance and the mean of the estimated portal vein perfusion in the functional liver parenchyma (p < 0.001).

Conclusion: This study reveals substantial individual variability in the sensitivity of the liver to irradiation. In addition, these findings suggest that hepatic perfusion imaging may be a marker for liver function and has the potential to be a tool for individualizing therapy.

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Conflict of interest statement

Conflicts of Interest Notification:

None of authors has any actual or potential conflicts of interest related to this study.

Figures

Figure 1
Figure 1
Scatter plots of regional portal vein perfusion (mL/(100g min)) one month after the completion of RT versus local dose (cGy) accumulated at the end of RT in two patients (open circles). The solid lines plot linear regression fits. The dashed lines represent the portal vein perfusion values prior to RT. Note that the values of portal vein perfusion prior to RT are smaller than the intercepts of linear regression, suggesting that while high dose causes a decrease in perfusion, low dose can result in an increase.
Figure 2
Figure 2
Spatial distribution of estimated portal vein perfusion in the whole liver parenchyma one month after RT in one patient. Portal vein perfusion is color-coded (in unit of mL/(100 g min)) and overlaid on the anatomical CT.
Figure 3
Figure 3
Linear correlations between the means of the estimated portal vein perfusion versus the half-life time of the ICG clearance one month after RT. In the left panel, the mean of portal vein perfusion was computed in the whole liver parenchyma (minus the gross tumor volume), while in the right panel only subunits having venous perfusion > 20 mL/(100 g min) were included in the mean. The solid lines represent the linear regression fit. The mean perfusion is in units of mL/(100 g min).
Figure 4
Figure 4
Scatter plot of the mean liver dose (cGy) versus the half-life of the ICG clearance (minutes) one month after RT. The correlation between the mean liver dose and the half-life of the ICG clearance was not significant (P > .4), suggesting the mean liver dose cannot accurately predict liver function after RT.
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References

    1. Ben-Josef E, Normolle D, Ensminger WD, et al. Phase II trial of high-dose conformal radiation therapy with concurrent hepatic artery floxuridine for unresectable intrahepatic malignancies. J Clin Oncol. 2005;23:8739–8747. - PubMed
    1. Emami B, Lyman J, Brown A, et al. Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys. 1991;21:109–122. - PubMed
    1. Lawrence TS, Robertson JM, Anscher MS, et al. Hepatic toxicity resulting from cancer treatment. Int J Radiat Oncol Biol Phys. 1995;31:1237–1248. - PubMed
    1. Gottlieb ME, Stratton HH, Newell JC, et al. Indocyanine green. Its use as an early indicator of hepatic dysfunction following injury in man. Arch Surg. 1984;119:264–268. - PubMed
    1. Hemming AW, Scudamore CH, Shackleton CR, et al. Indocyanine green clearance as a predictor of successful hepatic resection in cirrhotic patients. Am J Surg. 1992;163:515–518. - PubMed

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