PURPOSE: To evaluate whether liver function can be assessed globally and spatially by using volumetric dynamic contrast-enhanced magnetic resonance imaging MRI (DCE-MRI) to potentially aid in adaptive treatment planning. METHODS AND MATERIALS: Seventeen patients with intrahepatic cancer undergoing focal radiation therapy (RT) were enrolled in institution review board-approved prospective studies to obtain DCE-MRI (to measure regional perfusion) and indocyanine green (ICG) clearance rates (to measure overall liver function) prior to, during, and at 1 and 2 months after treatment. The volumetric distribution of portal venous perfusion in the whole liver was estimated for each scan. We assessed the correlation between mean portal venous perfusion in the nontumor volume of the liver and overall liver function measured by ICG before, during, and after RT. The dose response for regional portal venous perfusion to RT was determined using a linear mixed effects model. RESULTS: There was a significant correlation between the ICG clearance rate and mean portal venous perfusion in the functioning liver parenchyma, suggesting that portal venous perfusion could be used as a surrogate for function. Reduction in regional venous perfusion 1 month after RT was predicted by the locally accumulated biologically corrected dose at the end of RT (P<.0007). Regional portal venous perfusion measured during RT was a significant predictor for regional venous perfusion assessed 1 month after RT (P<.00001). Global hypovenous perfusion pre-RT was observed in 4 patients (3 patients with hepatocellular carcinoma and cirrhosis), 3 of whom had recovered from hypoperfusion, except in the highest dose regions, post-RT. In addition, 3 patients who had normal perfusion pre-RT had marked hypervenous perfusion or reperfusion in low-dose regions post-RT. CONCLUSIONS: This study suggests that MR-based volumetric hepatic perfusion imaging may be a biomarker for spatial distribution of liver function, which could aid in individualizing therapy, particularly for patients at risk for liver injury after RT.
PURPOSE: To evaluate whether liver function can be assessed globally and spatially by using volumetric dynamic contrast-enhanced magnetic resonance imaging MRI (DCE-MRI) to potentially aid in adaptive treatment planning. METHODS AND MATERIALS: Seventeen patients with intrahepatic cancer undergoing focal radiation therapy (RT) were enrolled in institution review board-approved prospective studies to obtain DCE-MRI (to measure regional perfusion) and indocyanine green (ICG) clearance rates (to measure overall liver function) prior to, during, and at 1 and 2 months after treatment. The volumetric distribution of portal venous perfusion in the whole liver was estimated for each scan. We assessed the correlation between mean portal venous perfusion in the nontumor volume of the liver and overall liver function measured by ICG before, during, and after RT. The dose response for regional portal venous perfusion to RT was determined using a linear mixed effects model. RESULTS: There was a significant correlation between the ICG clearance rate and mean portal venous perfusion in the functioning liver parenchyma, suggesting that portal venous perfusion could be used as a surrogate for function. Reduction in regional venous perfusion 1 month after RT was predicted by the locally accumulated biologically corrected dose at the end of RT (P<.0007). Regional portal venous perfusion measured during RT was a significant predictor for regional venous perfusion assessed 1 month after RT (P<.00001). Global hypovenous perfusion pre-RT was observed in 4 patients (3 patients with hepatocellular carcinoma and cirrhosis), 3 of whom had recovered from hypoperfusion, except in the highest dose regions, post-RT. In addition, 3 patients who had normal perfusion pre-RT had marked hypervenous perfusion or reperfusion in low-dose regions post-RT. CONCLUSIONS: This study suggests that MR-based volumetric hepatic perfusion imaging may be a biomarker for spatial distribution of liver function, which could aid in individualizing therapy, particularly for patients at risk for liver injury after RT.
Authors: Yue Cao; Jonathan Alspaugh; Zhou Shen; James M Balter; Theodore S Lawrence; Randall K Ten Haken Journal: Med Phys Date: 2006-08 Impact factor: 4.071
Authors: M Oellerich; M Burdelski; H U Lautz; B Rodeck; J Duewel; M Schulz; F W Schmidt; J Brodehl; R Pichlmayr Journal: Transplantation Date: 1991-04 Impact factor: 4.939
Authors: Yue Cao; Joel F Platt; Isaac R Francis; James M Balter; Charlie Pan; Daniel Normolle; Edgar Ben-Josef; Randall K Ten Haken; Theodore S Lawrence Journal: Med Phys Date: 2007-02 Impact factor: 4.071
Authors: Edgar Ben-Josef; Daniel Normolle; William D Ensminger; Suzette Walker; Daniel Tatro; Randall K Ten Haken; James Knol; Laura A Dawson; Charlie Pan; Theodore S Lawrence Journal: J Clin Oncol Date: 2005-12-01 Impact factor: 44.544
Authors: Laura A Dawson; Daniel Normolle; James M Balter; Cornelius J McGinn; Theodore S Lawrence; Randall K Ten Haken Journal: Int J Radiat Oncol Biol Phys Date: 2002-07-15 Impact factor: 7.038
Authors: Yue Cao; 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 Journal: Int J Radiat Oncol Biol Phys Date: 2007-09-12 Impact factor: 7.038
Authors: Stephen R Bowen; Jatinder Saini; Tobias R Chapman; Robert S Miyaoka; Paul E Kinahan; George A Sandison; Tony Wong; Hubert J Vesselle; Matthew J Nyflot; Smith Apisarnthanarax Journal: Radiother Oncol Date: 2015-04-28 Impact factor: 6.280
Authors: Daniel F Polan; Mary Feng; Theodore S Lawrence; Randall K Ten Haken; Kristy K Brock Journal: Int J Radiat Oncol Biol Phys Date: 2017-06-27 Impact factor: 7.038
Authors: Hesheng Wang; Mary Feng; Kirk A Frey; Randall K Ten Haken; Theodore S Lawrence; Yue Cao Journal: Int J Radiat Oncol Biol Phys Date: 2013-05-18 Impact factor: 7.038