Michael Sørensen1,2,3, Mette Marie Fode4, Jørgen Baltzer Petersen5, Marianne Ingerslev Holt4,6, Morten Høyer7. 1. Departement of Nuclear Medicine & PET, Aarhus University Hospital, Aarhus N, Denmark. michsoer@rm.dk. 2. Departement of Hepatology & Gastroenterology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, C116, 8200, Aarhus N, Denmark. michsoer@rm.dk. 3. Department of Internal Medicine, Viborg Regional Hospital, Viborg, Denmark. michsoer@rm.dk. 4. Departement of Oncology, Aarhus University Hospital, Aarhus N, Denmark. 5. Departement of Medical Physics, Aarhus University Hospital, Aarhus N, Denmark. 6. Department of Genetics, Vejle Hospital, Vejle, Denmark. 7. Danish Centre for Particle Therapy, Aarhus University Hospital, Aarhus N, Denmark.
Abstract
PURPOSE: Stereotactic body radiotherapy (SBRT) is increasingly used for treatment of liver tumors but the effect on metabolic liver function in surrounding tissue is largely unknown. Using 2-deoxy-2-[18F]fluoro-D-galactose ([18F]FDGal) positron emission tomography (PET)/computed tomography (CT), we aimed to determine a dose-response relationship between radiation dose and metabolic liver function as well as recovery. PROCEDURES: One male subject with intrahepatic cholangiocarcinoma and five subjects (1 female, 4 male) with liver metastases from colorectal cancer (mCRC) underwent [18F]FDGal PET/CT before SBRT and after 1 and 3 months. The dose response was calculated using the data after 1 month and the relative recovery was evaluated after 3 months. All patients had normal liver function at time of inclusion. RESULTS: A linear dose-response relationship for the individual liver voxel dose was seen until approximately 30 Gy. By fitting a polynomial curve to data, a mean TD50 of 18 Gy was determined with a 95% CI from 12 to 26 Gy. After 3 months, a substantial recovery was observed except in tissue receiving more than 25 Gy. CONCLUSIONS: [18F]FDGal PET/CT makes it possible to determine a dose-response relationship between radiation dose and metabolic liver function, here with a TD50 of 18 Gy (95% CI 12-26 Gy). Moreover, the method makes it possible to estimate metabolic recovery in liver tissue.
PURPOSE: Stereotactic body radiotherapy (SBRT) is increasingly used for treatment of liver tumors but the effect on metabolic liver function in surrounding tissue is largely unknown. Using 2-deoxy-2-[18F]fluoro-D-galactose ([18F]FDGal) positron emission tomography (PET)/computed tomography (CT), we aimed to determine a dose-response relationship between radiation dose and metabolic liver function as well as recovery. PROCEDURES: One male subject with intrahepatic cholangiocarcinoma and five subjects (1 female, 4 male) with liver metastases from colorectal cancer (mCRC) underwent [18F]FDGal PET/CT before SBRT and after 1 and 3 months. The dose response was calculated using the data after 1 month and the relative recovery was evaluated after 3 months. All patients had normal liver function at time of inclusion. RESULTS: A linear dose-response relationship for the individual liver voxel dose was seen until approximately 30 Gy. By fitting a polynomial curve to data, a mean TD50 of 18 Gy was determined with a 95% CI from 12 to 26 Gy. After 3 months, a substantial recovery was observed except in tissue receiving more than 25 Gy. CONCLUSIONS: [18F]FDGal PET/CT makes it possible to determine a dose-response relationship between radiation dose and metabolic liver function, here with a TD50 of 18 Gy (95% CI 12-26 Gy). Moreover, the method makes it possible to estimate metabolic recovery in liver tissue.
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