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Author
Fukugawa, Yoshiyuki Department of Radiation Oncology, Kumamoto University Hospital
Namimoto, Tomohiro Department of Diagnostic Radiology, Kumamoto University Hospital
Toya, Ryo Department of Radiation Oncology, Kumamoto University Hospital
Saito, Tetsuo Department of Radiation Oncology, Kumamoto University Hospital
Yuki, Hideaki Department of Diagnostic Radiology, Kumamoto University Hospital
Matsuyama, Tomohiko Department of Radiation Oncology, Kumamoto University Hospital
Ikeda, Osamu Department of Diagnostic Radiology, Kumamoto University Hospital
Yamashita, Yasuyuki Department of Diagnostic Radiology, Kumamoto University Hospital
Oya, Natsuo Department of Radiation Oncology, Kumamoto University Hospital
Abstract
Focal liver reaction (FLR) appears in the hepatobiliary-phase images of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (Gd-EOB-DTPA-enhanced MRI) following radiotherapy (RT). We investigated the threshold dose (TD) for FLR development in 13 patients with hepatocellular carcinoma (HCC) who underwent three-dimensional conformal radiotherapy (3D-CRT) with 45 Gy in 15 fractions. FLR volumes (FLRVs) were calculated based on planning CT images by referring to fused hepatobiliary-phase images. We also calculated the TD and the irradiated volumes (IVs) of the liver parenchyma at a given dose of every 5 Gy (IVdose) based on a dose-volume histogram (DVH). The median TD was 35.2 Gy. The median IV20, IV25, IV30, IV35, IV40, and IV45 values were 371.1, 274.8, 233.4, 188.6, 145.8, and 31.0 ml, respectively. The median FLRV was 144.9 ml. There was a significant difference between the FLRV and IV20, IV25, and IV45 (p<0.05), but no significant differences between the FLRV and IV30, IV35, or IV40. These results suggest that the threshold dose of the FLR is approx. 35 Gy in HCC patients who undergo 3D-CRT in 15 fractions. The percentage of the whole liver volume receiving a dose of more than 30-40 Gy (V30-40) is a potential candidate optimal DVH parameter for this fractionation schedule.
Keywords
Gd-EOB-DTPA
hepatocellular carcinoma
magnetic resonance imaging
radiation-induced liver disease
radiotherapy
Published Date
2017-02
Publication Title
Acta Medica Okayama
Volume
volume71
Issue
issue1
Publisher
Okayama University Medical School
Start Page
25
End Page
29
ISSN
0386-300X
NCID
AA00508441
Content Type
Journal Article
language
英語
Copyright Holders
CopyrightⒸ 2017 by Okayama University Medical School
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publisher
Refereed
True
PubMed ID
Amo Type
Original Article
Submission Path
amo/vol71/iss1/4
JaLCDOI