Liver function after irradiation based on computed tomographic portal vein perfusion imaging
Liver function after irradiation based on computed tomographic portal vein perfusion imaging
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DOI：
10.1016/j.ijrobp.2007.05.078
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发表时间：
2008-01-01
影响因子：
7
通讯作者：
Lawrence, Theodore S.
中科院分区：
文献类型：
--
作者：
Cao, Yue;Pan, Charlie;Lawrence, Theodore S.
目的：探讨动态增强CT扫描在治疗过程中能否通过测量肝脏血流灌注来评估个体和局部肝脏对放射治疗的敏感性。方法和材料：对接受适形放射治疗的肝癌患者在治疗前、治疗中和治疗后1个月分别进行动态增强CT扫描(测量血流灌注分布)和吲哚青氨酸提取研究(测量肝功能)。我们希望确定残余功能肝脏(即显示门静脉血流灌注的区域)是否可以用来预测放疗后的整体肝功能。结果：45~84Gy射线照射导致治疗后1个月无法检测到局部门静脉血流灌注。无法检测到门静脉血流的每个肝脏的体积从0到39%不等，这取决于患者的敏感性和剂量分布。吲哚青绿清除量与功能肝实质门静脉血流灌注值的平均值有显著相关性(p<；0.001)。结论：这项研究揭示了肝脏对辐射的敏感性存在显著的个体差异。此外，这些发现表明，肝脏灌注成像可能是肝功能的一个标志，并有可能成为个体化治疗的工具。(C)2008年爱思唯尔公司。
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 I 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. (c) 2008 Elsevier Inc.