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Title: Radiation-Induced Liver Damage: Correlation of Histopathology with Hepatobiliary Magnetic Resonance Imaging, a Feasibility Study

PurposeRadiotherapy of liver malignancies shows promising results (radioembolization, stereotactic irradiation, interstitial brachytherapy). Regardless of the route of application, a certain amount of nontumorous liver parenchyma will be collaterally damaged by radiation. The functional reserve may be significantly reduced with an impact on further treatment planning. Monitoring of radiation-induced liver damage by imaging is neither established nor validated. We performed an analysis to correlate the histopathological presence of radiation-induced liver damage with functional magnetic resonance imaging (MRI) utilizing hepatobiliary contrast media (Gd-BOPTA).MethodsPatients undergoing local high-dose-rate brachytherapy for whom a follow-up hepatobiliary MRI within 120 days after radiotherapy as well as an evaluable liver biopsy from radiation-exposed liver tissue within 7 days before MRI were retrospectively identified. Planning computed tomography (CT)/dosimetry was merged to the CT-documentation of the liver biopsy and to the MRI. Presence/absence of radiation-induced liver damage (histopathology) and Gd-BOPTA uptake (MRI) as well as the dose applied during brachytherapy at the site of tissue sampling was determined.ResultsFourteen biopsies from eight patients were evaluated. In all cases with histopathological evidence of radiation-induced liver damage (n = 11), no uptake of Gd-BOPTA was seen. In the remaining three, cases no radiation-induced liver damage but Gd-BOPTA uptake was seen. Presence of radiation-induced liver damage and absencemore » of Gd-BOPTA uptake was correlated with a former high-dose exposition.ConclusionsAbsence of hepatobiliary MRI contrast media uptake in radiation-exposed liver parenchyma may indicate radiation-induced liver damage. Confirmatory studies are warranted.« less
Authors:
 [1] ;  [2] ;  [3] ;  [4] ;  [5] ;  [6] ;  [7] ; ; ; ;  [1]
  1. Universitätsklinik Magdeburg, Klinik für Radiologie und Nuklearmedizin (Germany)
  2. Pomeranian Medical University, Department of Diagnostic Imaging and Interventional Radiology (Poland)
  3. Universitätsklinik Magdeburg, Institut für Pathologie (Germany)
  4. Universitätsklinik Magdeburg, Klinik für Allgemein-, Viszeral- und Gefäßchirurgie (Germany)
  5. Philipps Universität Marburg, Fachbereich Medizin der, Abteilung für Neuropathologie (Germany)
  6. Charité Universitätsmedizin Berlin, Klinik für Radioonkologie und Strahlentherapie (Germany)
  7. Universitätsklinik Magdeburg, Institut für Biometrie und Medizinische Informatik (Germany)
Publication Date:
OSTI Identifier:
22470112
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 38; Journal Issue: 1; Conference: IROS 2015: Interventional Radiological Olbert Symposium, Berlin (Germany), 15-17 Jan 2015; Other Information: Copyright (c) 2015 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ANIMAL TISSUES; BIOMEDICAL RADIOGRAPHY; BIOPSY; COMPUTERIZED TOMOGRAPHY; CONTRAST MEDIA; DAMAGE; DOCUMENTATION; DOSE RATES; DOSIMETRY; IRRADIATION; LIVER; MONITORING; NEOPLASMS; NMR IMAGING; PATIENTS; PLANNING; RADIATION DOSES; RADIOEMBOLIZATION; SAMPLING; UPTAKE