Regional Radiation Dose-Response Modeling of Functional Liver in Hepatocellular Carcinoma Patients With Longitudinal Sulfur Colloid SPECT/CT: A Proof of Concept

Stereotactic Ablative Radiotherapy (SABR/SBRT) for Hepatocellular Carcinoma

“…The primary consideration is sparing of non-tumor involved liver tissue [31,32]. Integration of patient-specific functional imaging may further aid in the treatment planning process to limit radiation-induced toxicities [33][34][35][36][37]. Selection of dose-fractionation scheme for a given patient remains an active area of investigation.…”

Gadoxetic Acid Uptake Rate as a Measure of Global and Regional Liver Function as Compared With Indocyanine Green Retention, Albumin-Bilirubin Score, and Portal Venous Perfusion

“…MRI and SPECT imaging techniques have been used to measure spatially resolved liver function 20,32 .…”

“…MRI and SPECT imaging techniques have been used to measure spatially resolved liver function. 20 , 32 DGAE MRI scans allow assessments of hepatocyte function through contrast uptake, rather than assuming uniform function or interrogating the “plumbing” of the liver as in perfusion studies. Quantitative assessment of the extent of function in the regional units (voxels) allows one to compute a sum of the function of units as a measure of global liver function.…”

The increasing potential of nuclear medicine imaging for the evaluation and reduction of normal tissue toxicity from radiation treatments

“…A proof of concept study that used [ 99m Tc]Tc-sulfur colloid, particles that are phagocytised by the Kupffer cells in the liver, measured regional dose response of functional liver in patients with hepatocellular carcinoma who received SBRT or proton therapy using SPECT/CT (Fig. 3) [70]. They found high interpatient variability, indicating patient-specific radiosensitivity, which was predictive for long-term toxicity.…”

“…3 Planning CT (a) and longitudinal 99m Tc-sulfur colloid SPECT images, baseline (b) and 1 month post-treatment (c), acquired for a patient who received proton therapy for liver cancer. This image was reproduced from Price et al with permission [70] are several other tissues that have been observed to show increased [ 18 F]FDG uptake on post-radiation therapy PET scans, due to radiation-induced inflammation. Radiation esophagitis has been shown to correlate strongly with increased [ 18 F]FDG uptake on post-therapy PET scans [118][119][120].…”