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05.08.2023 | Hepatobiliary

Liver parenchymal changes detected by MR elastography and diffusion-weighted imaging after stereotactic body radiotherapy for hepatocellular carcinoma

verfasst von: Yoshie Omiya, Hiroyuki Morisaka, Masaki Matsuda, Masahide Saito, Takaaki Hashimoto, Utaroh Motosugi, Hiroshi Onishi

Erschienen in: Abdominal Radiology | Ausgabe 11/2023

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Abstract

Background

Stereotactic body radiotherapy (SBRT) is a local treatment option for hepatocellular carcinoma (HCC). SBRT-induced focal reactions on the liver parenchyma have not been thoroughly evaluated using quantitative magnetic resonance imaging (MRI).

Purpose

To quantitatively evaluate liver parenchymal changes caused by SBRT for HCC using magnetic resonance elastography (MRE) and diffusion-weighted imaging (DWI).

Method

We retrospectively evaluated 22 adult patients who received SBRT for HCC and 27 who received locoregional therapy other than SBRT (controls). Liver stiffness by MRE and apparent diffusion coefficient (ADC) values by DWI of the liver parenchyma were measured before and after SBRT. Regions of interest (ROIs) were drawn on the two areas of radiation dose distribution levels, > 30 Gy and ≤ 30 Gy; a ROI was drawn in the control group. The two indices were compared before and after SBRT using a Wilcoxon matched-pairs signed-rank test.

Results

Liver stiffness and ADC values were significantly increased after SBRT in the dose areas of > 30 Gy compared with those before SBRT (4.05 vs 4.85 kPa; p < 0.05 in liver stiffness, and 1.10 vs 1.40 ×10−3 s/mm2; p < 0.05 in ADC values). In the dose area of ≦ 30 Gy, liver stiffness showed a significant increase in one reader (p = 0.033) but not in another reader (p = 0.085); ADC value showed no significant difference before and after SBRT as per both readers (p > 0.05). The control group demonstrated no significant differences before and after treatment (p > 0.05).

Conclusion

MRE and DWI can be used to detect SBRT-induced liver parenchymal changes.
Literatur
2.
Zurück zum Zitat A. Takeda, N. Sanuki, Y. Tsurugai, S. Iwabuchi, K. Matsunaga, H. Ebinuma, K. Imajo, Y. Aoki, H. Saito, E. Kunieda (2016) Phase 2 study of stereotactic body radiotherapy and optional transarterial chemoembolization for solitary hepatocellular carcinoma not amenable to resection and radiofrequency ablation. Cancer:122 2041-9.https://doi.org/10.1002/cncr.30008CrossRefPubMed A. Takeda, N. Sanuki, Y. Tsurugai, S. Iwabuchi, K. Matsunaga, H. Ebinuma, K. Imajo, Y. Aoki, H. Saito, E. Kunieda (2016) Phase 2 study of stereotactic body radiotherapy and optional transarterial chemoembolization for solitary hepatocellular carcinoma not amenable to resection and radiofrequency ablation. Cancer:122 2041-9.https://​doi.​org/​10.​1002/​cncr.​30008CrossRefPubMed
3.
Zurück zum Zitat F. Wang, K. Numata, A. Takeda, K. Ogushi, H. Fukuda, K. Hara, M. Chuma, T. Eriguchi, Y. Tsurugai, S. Maeda (2021) Safety and efficacy study: Short-term application of radiofrequency ablation and stereotactic body radiotherapy for Barcelona Clinical Liver Cancer stage 0-B1 hepatocellular carcinoma. PLoS One:16 e0245076.https://doi.org/10.1371/journal.pone.0245076 F. Wang, K. Numata, A. Takeda, K. Ogushi, H. Fukuda, K. Hara, M. Chuma, T. Eriguchi, Y. Tsurugai, S. Maeda (2021) Safety and efficacy study: Short-term application of radiofrequency ablation and stereotactic body radiotherapy for Barcelona Clinical Liver Cancer stage 0-B1 hepatocellular carcinoma. PLoS One:16 e0245076.https://​doi.​org/​10.​1371/​journal.​pone.​0245076
6.
Zurück zum Zitat A. Mendez Romero, W. Wunderink, S.M. Hussain, J.A. De Pooter, B.J. Heijmen, P.C. Nowak, J.J. Nuyttens, R.P. Brandwijk, C. Verhoef, J.N. Ijzermans, P.C. Levendag (2006) Stereotactic body radiation therapy for primary and metastatic liver tumors: A single institution phase i-ii study. Acta Oncol:45 831-7.https://doi.org/10.1080/02841860600897934CrossRefPubMed A. Mendez Romero, W. Wunderink, S.M. Hussain, J.A. De Pooter, B.J. Heijmen, P.C. Nowak, J.J. Nuyttens, R.P. Brandwijk, C. Verhoef, J.N. Ijzermans, P.C. Levendag (2006) Stereotactic body radiation therapy for primary and metastatic liver tumors: A single institution phase i-ii study. Acta Oncol:45 831-7.https://​doi.​org/​10.​1080/​0284186060089793​4CrossRefPubMed
7.
Zurück zum Zitat A. Moore, M. Cohen-Naftaly, A. Tobar, Y. Kundel, O. Benjaminov, M. Braun, A. Issachar, E. Mor, M. Sarfaty, D. Bragilovski, R.B. Hur, N. Gordon, S.M. Stemmer, A.M. Allen (2017) Stereotactic body radiation therapy (SBRT) for definitive treatment and as a bridge to liver transplantation in early stage inoperable Hepatocellular carcinoma. Radiat Oncol:12 163.https://doi.org/10.1186/s13014-017-0899-4 A. Moore, M. Cohen-Naftaly, A. Tobar, Y. Kundel, O. Benjaminov, M. Braun, A. Issachar, E. Mor, M. Sarfaty, D. Bragilovski, R.B. Hur, N. Gordon, S.M. Stemmer, A.M. Allen (2017) Stereotactic body radiation therapy (SBRT) for definitive treatment and as a bridge to liver transplantation in early stage inoperable Hepatocellular carcinoma. Radiat Oncol:12 163.https://​doi.​org/​10.​1186/​s13014-017-0899-4
9.
Zurück zum Zitat N. Sanuki, A. Takeda, Y. Oku, T. Eriguchi, S. Nishimura, Y. Aoki, T. Mizuno, S. Iwabuchi, E. Kunieda (2014) Threshold doses for focal liver reaction after stereotactic ablative body radiation therapy for small hepatocellular carcinoma depend on liver function: evaluation on magnetic resonance imaging with Gd-EOB-DTPA. Int J Radiat Oncol Biol Phys:88 306-11.https://doi.org/10.1016/j.ijrobp.2013.10.045CrossRefPubMed N. Sanuki, A. Takeda, Y. Oku, T. Eriguchi, S. Nishimura, Y. Aoki, T. Mizuno, S. Iwabuchi, E. Kunieda (2014) Threshold doses for focal liver reaction after stereotactic ablative body radiation therapy for small hepatocellular carcinoma depend on liver function: evaluation on magnetic resonance imaging with Gd-EOB-DTPA. Int J Radiat Oncol Biol Phys:88 306-11.https://​doi.​org/​10.​1016/​j.​ijrobp.​2013.​10.​045CrossRefPubMed
11.
Zurück zum Zitat M.J. Park, S.Y. Kim, S.M. Yoon, J.H. Kim, S.H. Park, S.S. Lee, Y. Lee, M.G. Lee (2014) Stereotactic body radiotherapy-induced arterial hypervascularity of non-tumorous hepatic parenchyma in patients with hepatocellular carcinoma: potential pitfalls in tumor response evaluation on multiphase computed tomography. PLoS One:9 e90327.https://doi.org/10.1371/journal.pone.0090327 M.J. Park, S.Y. Kim, S.M. Yoon, J.H. Kim, S.H. Park, S.S. Lee, Y. Lee, M.G. Lee (2014) Stereotactic body radiotherapy-induced arterial hypervascularity of non-tumorous hepatic parenchyma in patients with hepatocellular carcinoma: potential pitfalls in tumor response evaluation on multiphase computed tomography. PLoS One:9 e90327.https://​doi.​org/​10.​1371/​journal.​pone.​0090327
13.
Zurück zum Zitat M.M. Haddad, K.W. Merrell, C.L. Hallemeier, G.B. Johnson, T. Mounajjed, K.R. Olivier, J.L. Fidler, S.K. Venkatesh (2016) Stereotactic body radiation therapy of liver tumors: post-treatment appearances and evaluation of treatment response: a pictorial review. Abdom Radiol (NY):41 2061-77.https://doi.org/10.1007/s00261-016-0768-xCrossRefPubMed M.M. Haddad, K.W. Merrell, C.L. Hallemeier, G.B. Johnson, T. Mounajjed, K.R. Olivier, J.L. Fidler, S.K. Venkatesh (2016) Stereotactic body radiation therapy of liver tumors: post-treatment appearances and evaluation of treatment response: a pictorial review. Abdom Radiol (NY):41 2061-77.https://​doi.​org/​10.​1007/​s00261-016-0768-xCrossRefPubMed
14.
15.
Zurück zum Zitat M. Yin, K.J. Glaser, A. Manduca, T. Mounajjed, H. Malhi, D.A. Simonetto, R. Wang, L. Yang, S.A. Mao, J.M. Glorioso, F.M. Elgilani, C.J. Ward, P.C. Harris, S.L. Nyberg, V.H. Shah, R.L. Ehman (2017) Distinguishing between Hepatic Inflammation and Fibrosis with MR Elastography. Radiology:284 694-705.https://doi.org/10.1148/radiol.2017160622CrossRefPubMed M. Yin, K.J. Glaser, A. Manduca, T. Mounajjed, H. Malhi, D.A. Simonetto, R. Wang, L. Yang, S.A. Mao, J.M. Glorioso, F.M. Elgilani, C.J. Ward, P.C. Harris, S.L. Nyberg, V.H. Shah, R.L. Ehman (2017) Distinguishing between Hepatic Inflammation and Fibrosis with MR Elastography. Radiology:284 694-705.https://​doi.​org/​10.​1148/​radiol.​2017160622CrossRefPubMed
16.
Zurück zum Zitat J.J. Yoo, Y.S. Seo, Y.S. Kim, S.W. Jeong, J.Y. Jang, S.J. Suh, H.J. Yim, K.T. Suk, D.J. Kim, K.H. Han, S.U. Kim, B. Lee, S.G. Kim (2019) The Influence of Histologic Inflammation on the Improvement of Liver Stiffness Values Over 1 and 3 Years. J Clin Med:8.https://doi.org/10.3390/jcm8122065 J.J. Yoo, Y.S. Seo, Y.S. Kim, S.W. Jeong, J.Y. Jang, S.J. Suh, H.J. Yim, K.T. Suk, D.J. Kim, K.H. Han, S.U. Kim, B. Lee, S.G. Kim (2019) The Influence of Histologic Inflammation on the Improvement of Liver Stiffness Values Over 1 and 3 Years. J Clin Med:8.https://​doi.​org/​10.​3390/​jcm8122065
18.
Zurück zum Zitat M. Franca, L. Marti-Bonmati, A. Alberich-Bayarri, P. Oliveira, S. Guimaraes, J. Oliveira, J. Amorim, J.S. Gonzalez, J.R. Vizcaino, H.P. Miranda (2017) Evaluation of fibrosis and inflammation in diffuse liver diseases using intravoxel incoherent motion diffusion-weighted MR imaging. Abdom Radiol (NY):42 468-477.https://doi.org/10.1007/s00261-016-0899-0CrossRefPubMed M. Franca, L. Marti-Bonmati, A. Alberich-Bayarri, P. Oliveira, S. Guimaraes, J. Oliveira, J. Amorim, J.S. Gonzalez, J.R. Vizcaino, H.P. Miranda (2017) Evaluation of fibrosis and inflammation in diffuse liver diseases using intravoxel incoherent motion diffusion-weighted MR imaging. Abdom Radiol (NY):42 468-477.https://​doi.​org/​10.​1007/​s00261-016-0899-0CrossRefPubMed
22.
Zurück zum Zitat J.R. Landis, G.G. Koch (1977) The measurement of observer agreement for categorical data. Biometrics:33 159-74CrossRefPubMed J.R. Landis, G.G. Koch (1977) The measurement of observer agreement for categorical data. Biometrics:33 159-74CrossRefPubMed
24.
Zurück zum Zitat T. Kimura, S. Takahashi, I. Takahashi, I. Nishibuchi, Y. Doi, M. Kenjo, Y. Murakami, Y. Honda, H. Aikata, K. Chayama, Y. Nagata (2015) The Time Course of Dynamic Computed Tomographic Appearance of Radiation Injury to the Cirrhotic Liver Following Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma. PLoS One:10 e0125231.https://doi.org/10.1371/journal.pone.0125231 T. Kimura, S. Takahashi, I. Takahashi, I. Nishibuchi, Y. Doi, M. Kenjo, Y. Murakami, Y. Honda, H. Aikata, K. Chayama, Y. Nagata (2015) The Time Course of Dynamic Computed Tomographic Appearance of Radiation Injury to the Cirrhotic Liver Following Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma. PLoS One:10 e0125231.https://​doi.​org/​10.​1371/​journal.​pone.​0125231
Metadaten
Titel
Liver parenchymal changes detected by MR elastography and diffusion-weighted imaging after stereotactic body radiotherapy for hepatocellular carcinoma
verfasst von
Yoshie Omiya
Hiroyuki Morisaka
Masaki Matsuda
Masahide Saito
Takaaki Hashimoto
Utaroh Motosugi
Hiroshi Onishi
Publikationsdatum
05.08.2023
Verlag
Springer US
Erschienen in
Abdominal Radiology / Ausgabe 11/2023
Print ISSN: 2366-004X
Elektronische ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-023-03995-x

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