1. Radiation-induced liver damage: correlation of histopathology with hepatobiliary magnetic resonance imaging, a feasibility study.
- Author
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Seidensticker M, Burak M, Kalinski T, Garlipp B, Koelble K, Wust P, Antweiler K, Seidensticker R, Mohnike K, Pech M, and Ricke J
- Subjects
- Aged, Contrast Media, Feasibility Studies, Female, Humans, Image Enhancement, Liver ultrastructure, Male, Meglumine analogs & derivatives, Middle Aged, Organometallic Compounds, Brachytherapy adverse effects, Liver pathology, Liver radiation effects, Liver Neoplasms radiotherapy, Magnetic Resonance Imaging methods, Radiation Injuries diagnosis
- Abstract
Purpose: Radiotherapy 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)., Methods: Patients 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., Results: Fourteen 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 absence of Gd-BOPTA uptake was correlated with a former high-dose exposition., Conclusions: Absence of hepatobiliary MRI contrast media uptake in radiation-exposed liver parenchyma may indicate radiation-induced liver damage. Confirmatory studies are warranted.
- Published
- 2015
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