Background:Hepatic radiation injury severely restricts irradiation treatment for liver carcinoma.The purpose of this study was to investigate the clinical application of gadolinium ethoxybenzyl diethylenetriamine pent...Background:Hepatic radiation injury severely restricts irradiation treatment for liver carcinoma.The purpose of this study was to investigate the clinical application of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)-enhanced MRI(EOB-MRI)in the assessment of liver function after external radiation therapy and to determine the relationship between focal liver reaction(FLR)and liver function.Methods:A total of 47 patients with liver malignancies who underwent external beam radiation therapy were enrolled.EOB-MRI was performed on each patient at approximately one month post-radiotherapy.The hepatobiliary(HPB)phase images from EOB-MRI were fused with the planning CT images,and the isodose lines from the patients’treatment plans were overlaid onto the fused images.The correlation of the EOB-MR image intensity distribution with the isodose lines was studied.We also compared liver function in patients between pre-treatment and post-treatment.Results:Decreased uptake of Gd-EOB-DTPA,which was manifested by well-demarcated focal hypointensity of the liver parenchyma or FLR to high-dose radiation,was observed in the irradiated areas of 38 patients.The radiotherapy isodose line of decreased uptake area of Gd-EOB-DTPA was 30–46 Gy.The median corresponding dose curve of FLR was 34.4 Gy.Nine patients showed the absence of decreased uptake area of Gd-EOB-DTPA in the irradiated areas.Compared to the 38 patients with the presence of decreased uptake area of Gd-EOB-DTPA,9 patients with the absence of decreased uptake area of Gd-EOB-DTPA showed significant higher levels of total bile acid,total bilirubin,direct bilirubin and alpha-fetoprotein(P<0.05).There were no significant differences in alanine transaminase,aspartate aminotransferase,gamma-glutamyl transpeptidase or albumin levels between the two groups(P>0.05).Conclusions:Visible uptake of Gd-EOB-DTPA by the liver parenchyma was significantly associated with liver function parameters.EOB-MRI can be a valuable imaging biomarker for the assessment of展开更多
基金supported by grants from the Project of Health Commission of Zhejiang province(2014KYA075)Natural Science Foundation of Zhejiang province(2014C33199)
文摘Background:Hepatic radiation injury severely restricts irradiation treatment for liver carcinoma.The purpose of this study was to investigate the clinical application of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)-enhanced MRI(EOB-MRI)in the assessment of liver function after external radiation therapy and to determine the relationship between focal liver reaction(FLR)and liver function.Methods:A total of 47 patients with liver malignancies who underwent external beam radiation therapy were enrolled.EOB-MRI was performed on each patient at approximately one month post-radiotherapy.The hepatobiliary(HPB)phase images from EOB-MRI were fused with the planning CT images,and the isodose lines from the patients’treatment plans were overlaid onto the fused images.The correlation of the EOB-MR image intensity distribution with the isodose lines was studied.We also compared liver function in patients between pre-treatment and post-treatment.Results:Decreased uptake of Gd-EOB-DTPA,which was manifested by well-demarcated focal hypointensity of the liver parenchyma or FLR to high-dose radiation,was observed in the irradiated areas of 38 patients.The radiotherapy isodose line of decreased uptake area of Gd-EOB-DTPA was 30–46 Gy.The median corresponding dose curve of FLR was 34.4 Gy.Nine patients showed the absence of decreased uptake area of Gd-EOB-DTPA in the irradiated areas.Compared to the 38 patients with the presence of decreased uptake area of Gd-EOB-DTPA,9 patients with the absence of decreased uptake area of Gd-EOB-DTPA showed significant higher levels of total bile acid,total bilirubin,direct bilirubin and alpha-fetoprotein(P<0.05).There were no significant differences in alanine transaminase,aspartate aminotransferase,gamma-glutamyl transpeptidase or albumin levels between the two groups(P>0.05).Conclusions:Visible uptake of Gd-EOB-DTPA by the liver parenchyma was significantly associated with liver function parameters.EOB-MRI can be a valuable imaging biomarker for the assessment of
