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Title: Prediction of Liver Function by Using Magnetic Resonance-based Portal Venous Perfusion Imaging

Abstract

Purpose: To evaluate whether liver function can be assessed globally and spatially by using volumetric dynamic contrast-enhanced magnetic resonance imaging MRI (DCE-MRI) to potentially aid in adaptive treatment planning. Methods and Materials: Seventeen patients with intrahepatic cancer undergoing focal radiation therapy (RT) were enrolled in institution review board-approved prospective studies to obtain DCE-MRI (to measure regional perfusion) and indocyanine green (ICG) clearance rates (to measure overall liver function) prior to, during, and at 1 and 2 months after treatment. The volumetric distribution of portal venous perfusion in the whole liver was estimated for each scan. We assessed the correlation between mean portal venous perfusion in the nontumor volume of the liver and overall liver function measured by ICG before, during, and after RT. The dose response for regional portal venous perfusion to RT was determined using a linear mixed effects model. Results: There was a significant correlation between the ICG clearance rate and mean portal venous perfusion in the functioning liver parenchyma, suggesting that portal venous perfusion could be used as a surrogate for function. Reduction in regional venous perfusion 1 month after RT was predicted by the locally accumulated biologically corrected dose at the end of RT (P<.0007). Regionalmore » portal venous perfusion measured during RT was a significant predictor for regional venous perfusion assessed 1 month after RT (P<.00001). Global hypovenous perfusion pre-RT was observed in 4 patients (3 patients with hepatocellular carcinoma and cirrhosis), 3 of whom had recovered from hypoperfusion, except in the highest dose regions, post-RT. In addition, 3 patients who had normal perfusion pre-RT had marked hypervenous perfusion or reperfusion in low-dose regions post-RT. Conclusions: This study suggests that MR-based volumetric hepatic perfusion imaging may be a biomarker for spatial distribution of liver function, which could aid in individualizing therapy, particularly for patients at risk for liver injury after RT.« less

Authors:
 [1];  [2];  [1];  [3]; ; ; ; ; ;  [1]
  1. Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States)
  2. Department of Biostatistics, University of Michigan, Ann Arbor, Michigan (United States)
  3. Department of Radiology, University of Michigan, Ann Arbor, Michigan (United States)
Publication Date:
OSTI Identifier:
22149742
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 85; Journal Issue: 1; Other Information: Copyright (c) 2013 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BIOLOGICAL MARKERS; CLEARANCE; HAZARDS; HEPATOMAS; INDOCYANINE GREEN; INJURIES; LIVER; MAGNETIC RESONANCE; NMR IMAGING; PATIENTS; PLANNING; RADIATION DOSES; RADIOTHERAPY

Citation Formats

Cao Yue, E-mail: yuecao@umich.edu, Department of Radiology, University of Michigan, Ann Arbor, Michigan, Hesheng, Wang, Johnson, Timothy D., Pan, Charlie, Hussain, Hero, Balter, James M., Normolle, Daniel, Ben-Josef, Edgar, Ten Haken, Randall K., Lawrence, Theodore S., and Feng, Mary. Prediction of Liver Function by Using Magnetic Resonance-based Portal Venous Perfusion Imaging. United States: N. p., 2013. Web. doi:10.1016/J.IJROBP.2012.02.037.
Cao Yue, E-mail: yuecao@umich.edu, Department of Radiology, University of Michigan, Ann Arbor, Michigan, Hesheng, Wang, Johnson, Timothy D., Pan, Charlie, Hussain, Hero, Balter, James M., Normolle, Daniel, Ben-Josef, Edgar, Ten Haken, Randall K., Lawrence, Theodore S., & Feng, Mary. Prediction of Liver Function by Using Magnetic Resonance-based Portal Venous Perfusion Imaging. United States. https://doi.org/10.1016/J.IJROBP.2012.02.037
Cao Yue, E-mail: yuecao@umich.edu, Department of Radiology, University of Michigan, Ann Arbor, Michigan, Hesheng, Wang, Johnson, Timothy D., Pan, Charlie, Hussain, Hero, Balter, James M., Normolle, Daniel, Ben-Josef, Edgar, Ten Haken, Randall K., Lawrence, Theodore S., and Feng, Mary. 2013. "Prediction of Liver Function by Using Magnetic Resonance-based Portal Venous Perfusion Imaging". United States. https://doi.org/10.1016/J.IJROBP.2012.02.037.
@article{osti_22149742,
title = {Prediction of Liver Function by Using Magnetic Resonance-based Portal Venous Perfusion Imaging},
author = {Cao Yue, E-mail: yuecao@umich.edu and Department of Radiology, University of Michigan, Ann Arbor, Michigan and Hesheng, Wang and Johnson, Timothy D. and Pan, Charlie and Hussain, Hero and Balter, James M. and Normolle, Daniel and Ben-Josef, Edgar and Ten Haken, Randall K. and Lawrence, Theodore S. and Feng, Mary},
abstractNote = {Purpose: To evaluate whether liver function can be assessed globally and spatially by using volumetric dynamic contrast-enhanced magnetic resonance imaging MRI (DCE-MRI) to potentially aid in adaptive treatment planning. Methods and Materials: Seventeen patients with intrahepatic cancer undergoing focal radiation therapy (RT) were enrolled in institution review board-approved prospective studies to obtain DCE-MRI (to measure regional perfusion) and indocyanine green (ICG) clearance rates (to measure overall liver function) prior to, during, and at 1 and 2 months after treatment. The volumetric distribution of portal venous perfusion in the whole liver was estimated for each scan. We assessed the correlation between mean portal venous perfusion in the nontumor volume of the liver and overall liver function measured by ICG before, during, and after RT. The dose response for regional portal venous perfusion to RT was determined using a linear mixed effects model. Results: There was a significant correlation between the ICG clearance rate and mean portal venous perfusion in the functioning liver parenchyma, suggesting that portal venous perfusion could be used as a surrogate for function. Reduction in regional venous perfusion 1 month after RT was predicted by the locally accumulated biologically corrected dose at the end of RT (P<.0007). Regional portal venous perfusion measured during RT was a significant predictor for regional venous perfusion assessed 1 month after RT (P<.00001). Global hypovenous perfusion pre-RT was observed in 4 patients (3 patients with hepatocellular carcinoma and cirrhosis), 3 of whom had recovered from hypoperfusion, except in the highest dose regions, post-RT. In addition, 3 patients who had normal perfusion pre-RT had marked hypervenous perfusion or reperfusion in low-dose regions post-RT. Conclusions: This study suggests that MR-based volumetric hepatic perfusion imaging may be a biomarker for spatial distribution of liver function, which could aid in individualizing therapy, particularly for patients at risk for liver injury after RT.},
doi = {10.1016/J.IJROBP.2012.02.037},
url = {https://www.osti.gov/biblio/22149742}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 1,
volume = 85,
place = {United States},
year = {Tue Jan 01 00:00:00 EST 2013},
month = {Tue Jan 01 00:00:00 EST 2013}
}