Intraoperative Radiation Therapy in Liver Tissue in a Pig Model: Monitoring with Dual-Modality PET/CT

Antoch, Gerald; Kaiser, G.; Mueller, Andrea B.; Metz, K.; Zhang, Hongwei; Kuehl, Hilmar; Westermann, Stephanie; Broelsch, Christoph E.; Müeller, Stefan; Bockisch, Andreas; Debatin, Jörg F.

doi:10.1148/radiol.2303021183

Cited by 17 publications

(8 citation statements)

References 22 publications

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“…Antoch et al . [ 17 ] reported their findings of the utility of PET/CT in the assessment of liver tissue after intraoperative radiation therapy in a pig model. They found that PET/CT showed a decrease in the uptake of FDG in the irradiated field at 2 and at 4 weeks following completion of intraoperative therapy using 20 Gy.…”

Section: Discussionmentioning

confidence: 99%

PET/CT and hepatic radiation injury in esophageal cancer patients

et al. 2007

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This paper evaluates the imaging appearance of radiation injury in the liver on positron emission tomography (PET)/computed tomography (CT) in patients with distal esophageal cancer who underwent pre-operative chemoradiation therapy. Twenty-six patients with distal esophageal cancer who received chemoradiotherapy before esophagectomy were included. All patients had baseline and follow-up PET/CT. Fluorodeoxyglucose (FDG) uptake in both left and right lobes of the liver was evaluated. CT findings suggesting radiation damage were documented. Abnormal FDG uptake in the liver was observed in 5 (19%) patients after therapy. These abnormalities were in the left lobe (12%) and right lobe (12%) of the liver. In the irradiated left lobe, FDG uptake increased focally greater than 50% over baseline in two patients (54% and 133%); in one of these patients, biopsy confirmed radiation injury. In the non-irradiated right lobe, standard uptake values (SUV) increased diffusely in two different patients. In one patient, SUV decreased by at least 50% in both the right and left lobes. In the remaining patients, there were no significant changes in FDG uptake. Atrophy and attenuation changes of irradiated liver on CT were found in 15 (58%) patients. In patients receiving chemoradiotherapy, PET/CT may identify metabolic abnormalities in irradiated liver. Such abnormalities should be correlated with other imaging, clinical and laboratory findings to avoid confusion with hepatic metastases.

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Section: Discussionmentioning

confidence: 99%

PET/CT and hepatic radiation injury in esophageal cancer patients

et al. 2007

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“…The typical doses applied ranged from 15 to 30 Gy with reference to the tumor margin. The brachytherapy technique generally leads to a high dose inhomogeneity in the target volume [14][15][16][17][18] . However, the intraoperative approach has some drawbacks.…”

Section: Introductionmentioning

confidence: 99%

Image-Guided Interstitial High-Dose-Rate Brachytherapy in Hepatocellular Carcinoma

Mohnike

Wieners

Pech

et al. 2009

Dig Dis

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New interventional options especially for patients with HCC and BCLC scores B and C give rise to disputes about the optimal therapeutic management. CT-guided brachytherapy complements established interventional techniques like RFA and TACE since it may also be used successfully in tumors much greater than 5 cm in diameter. In addition, unlike thermal ablation, the brachytherapy technique may be applied in tumors located nearby risk structures such as liver hilum or gallbladder and it is independent of cooling effects such as through large blood vessels or strong tumor perfusion. Depending on tumor size, geometry and visibility, MRI or CT guidance may be used. 15 Gy minimal target dose can be applied safely in a single or – in case of very large tumors – a sequential approach targeting different tumor portions. Local recurrence rates will be very low, and the rate of complications is moderate despite the fact that most patients present with underlying cirrhosis and related comorbidities. Preliminary data suggest a positive impact on overall survival. Randomized controlled trials are on their way to assess combination schemes with systemic treatments such as sorafenib.

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“…The threshold dose for wholeliver irradiation without chemotherapy is supposed to be 20 -30 Gy (21,22). In patients who undergo combined radiation therapy and chemotherapy or combined radiation therapy and immunotherapy, the risk for development of radiation-induced liver disease is higher (23,24).…”

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confidence: 99%

x-Irradiation in Rat Liver: Consequent Upregulation of Hepcidin and Downregulation of Hemojuvelin and Ferroportin-1 Gene Expression

Christiansen¹,

Sheikh²,

Saile³

et al. 2007

Radiology

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Intraoperative Radiation Therapy in Liver Tissue in a Pig Model: Monitoring with Dual-Modality PET/CT

Abstract: The morphologic and functional changes due to IORT in liver tissue can be accurately monitored with dual-modality PET/CT. By enabling the integration of functional and morphologic data, PET/CT may have an important role in monitoring radiation treatment.

Cited by 17 publications

References 22 publications

PET/CT and hepatic radiation injury in esophageal cancer patients

PET/CT and hepatic radiation injury in esophageal cancer patients

Image-Guided Interstitial High-Dose-Rate Brachytherapy in Hepatocellular Carcinoma

x-Irradiation in Rat Liver: Consequent Upregulation of Hepcidin and Downregulation of Hemojuvelin and Ferroportin-1 Gene Expression

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