Inter-patient variations of radiation-induced normal-tissue changes in Gd-EOB-DTPA-enhanced hepatic MRI scans during fractionated proton therapy
Background and purpose: Previous MRI studies have shown a substantial decrease in normal-tissue uptake of a hepatobiliary-directed contrast agent 6–9 weeks after liver irradiation. In this prospective clinical study, we investigated whether this effect is detectable during the course of proton thera...
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| Format: | Article |
| Language: | English |
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Elsevier
2019-09-01
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| Series: | Clinical and Translational Radiation Oncology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405630818301253 |
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doaj-82c22c5cea82474bb9a351c3cc70481f |
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Article |
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DOAJ |
| language |
English |
| format |
Article |
| sources |
DOAJ |
| author |
Christian Richter Ovidiu C. Andronesi Ronald J.H. Borra Felix Voigt Steffen Löck Dan G. Duda Alexander R. Guimaraes Theodore S. Hong Thomas R. Bortfeld Joao Seco |
| spellingShingle |
Christian Richter Ovidiu C. Andronesi Ronald J.H. Borra Felix Voigt Steffen Löck Dan G. Duda Alexander R. Guimaraes Theodore S. Hong Thomas R. Bortfeld Joao Seco Inter-patient variations of radiation-induced normal-tissue changes in Gd-EOB-DTPA-enhanced hepatic MRI scans during fractionated proton therapy Clinical and Translational Radiation Oncology |
| author_facet |
Christian Richter Ovidiu C. Andronesi Ronald J.H. Borra Felix Voigt Steffen Löck Dan G. Duda Alexander R. Guimaraes Theodore S. Hong Thomas R. Bortfeld Joao Seco |
| author_sort |
Christian Richter |
| title |
Inter-patient variations of radiation-induced normal-tissue changes in Gd-EOB-DTPA-enhanced hepatic MRI scans during fractionated proton therapy |
| title_short |
Inter-patient variations of radiation-induced normal-tissue changes in Gd-EOB-DTPA-enhanced hepatic MRI scans during fractionated proton therapy |
| title_full |
Inter-patient variations of radiation-induced normal-tissue changes in Gd-EOB-DTPA-enhanced hepatic MRI scans during fractionated proton therapy |
| title_fullStr |
Inter-patient variations of radiation-induced normal-tissue changes in Gd-EOB-DTPA-enhanced hepatic MRI scans during fractionated proton therapy |
| title_full_unstemmed |
Inter-patient variations of radiation-induced normal-tissue changes in Gd-EOB-DTPA-enhanced hepatic MRI scans during fractionated proton therapy |
| title_sort |
inter-patient variations of radiation-induced normal-tissue changes in gd-eob-dtpa-enhanced hepatic mri scans during fractionated proton therapy |
| publisher |
Elsevier |
| series |
Clinical and Translational Radiation Oncology |
| issn |
2405-6308 |
| publishDate |
2019-09-01 |
| description |
Background and purpose: Previous MRI studies have shown a substantial decrease in normal-tissue uptake of a hepatobiliary-directed contrast agent 6–9 weeks after liver irradiation. In this prospective clinical study, we investigated whether this effect is detectable during the course of proton therapy. Material and methods: Gd-EOB-DTPA enhanced MRI was performed twice during hypo-fractionated proton therapy of liver lesions in 9 patients (plus two patients with only one scan available). Dose-correlated signal changes were qualitatively scored based on difference images from the two scans. We evaluated the correlation between the MRI signal change with the planned dose map. The GTV was excluded from all analyses. In addition, were examined timing, irradiated liver volume, changes in liver function parameters as well as circulating biomarkers of inflammation. Results: Strong, moderate or no dose-correlated signal changes were detected for 2, 3 and 5 patients, respectively. Qualitative scoring was consistent with the quantitative dose to signal change correlation. In an exploratory analysis, the strongest correlation was found between the qualitative scoring and pretreatment IL-6 concentration. For all patients, a clear dose-correlated signal decrease was seen in late follow-up scans. Conclusion: Radiation-induced effects can be detected with Gd-EOB-DTPA enhanced MRI in a subgroup of patients within a few days after proton irradiation. The reason for the large inter-patient variations is not yet understood and will require validation in larger studies. Keywords: Gd-EOB-DTPA, Liver, MRI, Radiation-induced changes, Inflammatory response, In vivo verification |
| url |
http://www.sciencedirect.com/science/article/pii/S2405630818301253 |
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doaj-82c22c5cea82474bb9a351c3cc70481f2021-06-02T08:10:38ZengElsevierClinical and Translational Radiation Oncology2405-63082019-09-0118113119Inter-patient variations of radiation-induced normal-tissue changes in Gd-EOB-DTPA-enhanced hepatic MRI scans during fractionated proton therapyChristian Richter0Ovidiu C. Andronesi1Ronald J.H. Borra2Felix Voigt3Steffen Löck4Dan G. Duda5Alexander R. Guimaraes6Theodore S. Hong7Thomas R. Bortfeld8Joao Seco9Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; OncoRay – National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; Department of Radiation Oncology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; Helmholtz-Zentrum Dresden – Rossendorf, Institute of Radiooncology – OncoRay, Dresden, Germany; Corresponding author at: OncoRay – National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USADepartment of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Medical Imaging Centre of Southwest Finland, Department of Diagnostic Radiology, Turku University Hospital, Turku, FinlandOncoRay – National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, GermanyOncoRay – National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; Department of Radiation Oncology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; Helmholtz-Zentrum Dresden – Rossendorf, Institute of Radiooncology – OncoRay, Dresden, GermanyDepartment of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USADepartment of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Division of Abdominal Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA; Medical Imaging Centre of Southwest Finland, Department of Diagnostic Radiology, Turku University Hospital, Turku, FinlandDepartment of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USADepartment of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USADepartment of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USABackground and purpose: Previous MRI studies have shown a substantial decrease in normal-tissue uptake of a hepatobiliary-directed contrast agent 6–9 weeks after liver irradiation. In this prospective clinical study, we investigated whether this effect is detectable during the course of proton therapy. Material and methods: Gd-EOB-DTPA enhanced MRI was performed twice during hypo-fractionated proton therapy of liver lesions in 9 patients (plus two patients with only one scan available). Dose-correlated signal changes were qualitatively scored based on difference images from the two scans. We evaluated the correlation between the MRI signal change with the planned dose map. The GTV was excluded from all analyses. In addition, were examined timing, irradiated liver volume, changes in liver function parameters as well as circulating biomarkers of inflammation. Results: Strong, moderate or no dose-correlated signal changes were detected for 2, 3 and 5 patients, respectively. Qualitative scoring was consistent with the quantitative dose to signal change correlation. In an exploratory analysis, the strongest correlation was found between the qualitative scoring and pretreatment IL-6 concentration. For all patients, a clear dose-correlated signal decrease was seen in late follow-up scans. Conclusion: Radiation-induced effects can be detected with Gd-EOB-DTPA enhanced MRI in a subgroup of patients within a few days after proton irradiation. The reason for the large inter-patient variations is not yet understood and will require validation in larger studies. Keywords: Gd-EOB-DTPA, Liver, MRI, Radiation-induced changes, Inflammatory response, In vivo verificationhttp://www.sciencedirect.com/science/article/pii/S2405630818301253 |