Liver Function After Irradiation Based on Computed Tomographic Portal Vein Perfusion Imaging

Overview

Journal Int J Radiat Oncol Biol Phys

Specialties Oncology
Radiology

Date 2007 Sep 15

PMID 17855011

Citations 27

Authors

Yue Cao

Charlie Pan

James M Balter

Joel F Platt

Isaac R Francis

James A Knol

Daniel Normolle

Edgar Ben-Josef

Randall K Ten Haken

Theodore S Lawrence

Affiliations

Soon will be listed here.

Abstract

Purpose: To determine whether individual and regional liver sensitivity to radiation could be assessed by measuring liver perfusion during a course of treatment using dynamic contrast-enhanced computed tomography scanning.

Methods And Materials: Patients with intrahepatic cancer undergoing conformal radiotherapy underwent dynamic contrast-enhanced computed tomography (to measure perfusion distribution) and an indocyanine extraction study (to measure liver function) before, during, and 1 month after treatment. We hoped to determine whether the residual functioning liver (i.e., those regions showing portal vein perfusion) could be used to predict overall liver function after irradiation.

Results: Radiation doses from 45 to 84 Gy resulted in undetectable regional portal vein perfusion 1 month after treatment. The volume of each liver with undetectable portal vein perfusion ranged from 0 to 39% and depended both on the patient's sensitivity and on dose distribution. There was a significant correlation between indocyanine green clearance and the mean of the estimated portal vein perfusion in the functional liver parenchyma (p < 0.001).

Conclusion: This study reveals substantial individual variability in the sensitivity of the liver to irradiation. In addition, these findings suggest that hepatic perfusion imaging may be a marker for liver function and has the potential to be a tool for individualizing therapy.

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