Stereotactic Body Radiotherapy with Functional Treatment Planning in Hepatocellular Carcinoma

Kirichenko, Alexander; Koay, Eugene J.; Hasan, Shaakir; Crane, Christopher H.

doi:10.1007/174_2017_42

Cited by 1 publication

(2 citation statements)

References 44 publications

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“…Building on our previous studies that used the nuclear medicine platform for liver SBRT planning [ 22 , 23 , 24 , 25 , 26 ], this study demonstrated that the use of a SPION-CA can enhance voxel-wise liver heterogeneity, and it can be advanced for the quantitative auto-contouring of FLPV(s) for the functional planning of liver SBRT. The present study used a SPION-CA to identify the FLPV, but the same approach could be used for visualizing liver tumors and the FLPV during MR-guided online adaptive radiotherapy [ 39 ].…”

Section: Discussionmentioning

confidence: 82%

“…We previously demonstrated that functional radiation treatment planning for liver stereotactic body radiotherapy (SBRT) with a 99mTc sulfur colloid SPECT/CT allows the identification and avoidance of Kupffer-cell-rich FLPVs in patients with hepatocellular carcinomas and advanced hepatic cirrhosis by lowering toxicity and promoting greater local tumor control [ 22 , 23 , 24 , 25 , 26 ]. Our current study utilized T2*- and R2*-MRI to measure the susceptibility-related signal changes enhanced by SPION uptake in the hepatic Kupffer cells.…”

Section: Introductionmentioning

confidence: 99%

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Quantifying Liver Heterogeneity via R2*-MRI with Super-Paramagnetic Iron Oxide Nanoparticles (SPION) to Characterize Liver Function and Tumor

Lee

Sohn

Kirichenko

2022

Cancers

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The use of super-paramagnetic iron oxide nanoparticles (SPIONs) as an MRI contrast agent (SPION-CA) can safely label hepatic macrophages and be localized within hepatic parenchyma for T2*- and R2*-MRI of the liver. To date, no study has utilized the R2*-MRI with SPIONs for quantifying liver heterogeneity to characterize functional liver parenchyma (FLP) and hepatic tumors. This study investigates whether SPIONs enhance liver heterogeneity for an auto-contouring tool to identify the voxel-wise functional liver parenchyma volume (FLPV). This was the first study to directly evaluate the impact of SPIONs on the FLPV in R2*-MRI for 12 liver cancer patients. By using SPIONs, liver heterogeneity was improved across pre- and post-SPION MRI sessions. On average, 60% of the liver [range 40–78%] was identified as the FLPV in our auto-contouring tool with a pre-determined threshold of the mean R2* of the tumor and liver. This method performed well in 10 out of 12 liver cancer patients; the remaining 2 needed a longer echo time. These results demonstrate that our contouring tool with SPIONs can facilitate the heterogeneous R2* of the liver to automatically characterize FLP. This is a desirable technique for achieving more accurate FLPV contouring during liver radiation treatment planning.

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