Limits...
CT Imaging Findings after Stereotactic Radiotherapy for Liver Tumors.

Brook OR, Thornton E, Mendiratta-Lala M, Mahadevan A, Raptopoulos V, Brook A, Najarian R, Sheiman R, Siewert B - Gastroenterol Res Pract (2015)

Bottom Line: Partial response (>30% decrease in long diameter) was seen in 25/36 (69%) HCCs, 14/25 (58%) metastases, and 7/7 (100%) of CCCs.Conclusion.Prominent halo of delayed enhancement of the adjacent liver is frequent finding.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA.

ABSTRACT
Purpose. To study radiological response to stereotactic radiotherapy for focal liver tumors. Materials and Methods. In this IRB-approved, HIPAA-compliant study CTs of 68 consecutive patients who underwent stereotactic radiotherapy for liver tumors between 01/2006 and 01/2010 were retrospectively reviewed. Two independent reviewers evaluated lesion volume and enhancement pattern of the lesion and of juxtaposed liver parenchyma. Results. 36 subjects with hepatocellular carcinoma (HCC), 25 with liver metastases, and seven with cholangiocarcinoma (CCC) were included in study. Mean follow-up time was 5.6 ± 7.1 months for HCC, 6.4 ± 5.1 months for metastases, and 10.1 ± 4.8 months for the CCC. Complete response was seen in 4/36 (11.1%) HCCs and 1/25 (4%) metastases. Partial response (>30% decrease in long diameter) was seen in 25/36 (69%) HCCs, 14/25 (58%) metastases, and 7/7 (100%) of CCCs. Partial response followed by local recurrence (>20% increase in long diameter from nadir) occurred in 2/36 (6%) HCCs and 4/25 (17%) metastases. Liver parenchyma adjacent to the lesion demonstrated a prominent halo of delayed enhancement in 27/36 (78%) of HCCs, 19/21 (91%) of metastases, and 7/7 (100%) of CCCs. Conclusion. Sustainable radiological partial response to stereotactic radiotherapy is most frequent outcome seen in liver lesions. Prominent halo of delayed enhancement of the adjacent liver is frequent finding.

No MeSH data available.


Related in: MedlinePlus

Nonenhancing area within the treated metastatic lesion over the follow-up period (each line represents an individual lesion).
© Copyright Policy - open-access
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4499630&req=5

fig7: Nonenhancing area within the treated metastatic lesion over the follow-up period (each line represents an individual lesion).

Mentions: There were 20 patients with 24 metastases treated in the study. The metastases were from colon cancer in 7 patients, melanoma in 4 patients, lung, breast, and pancreas carcinoma in 2 patients each, and renal, duodenal carcinomas, and carcinoid in one patient each. Patients clinical characteristics are described in Table 1. The patients were treated with mean total dose of 3400 ± 717 cGy (range 2400–4500 cGy), in median 3 (range 1–5) fractions with mean dose of 1183 ± 362 cGy (range 600–2400 cGy) per fraction. The mean lesion volume was 127  ±  152 cc, median 80 cc (range 4–524 cc). The mean lesion coverage was 95  ±  2% (range 90–99%). The average prescription isodose was 77  ±  4% (range 66–84%). All patients were previously treated with chemotherapy; however none were treated with chemotherapy during the stereotactic radiotherapy treatment. Complete response was seen in 1/25 lesions (4%), partial response in 14/25 lesions (58%), and partial response followed by local recurrence in 4/25 lesions (17%). For the patients with either complete response or partial response there was a significant difference between the volume prior to and after treatment (p = 0.02). The dynamics of the volume changes over the follow-up time can be seen in Figure 6. The area without enhancement within the treated metastatic lesion rose on the first follow-up study (15–45 days after treatment) and in most of the cases did not change significantly over the follow-up period unless a recurrence occurred (Figure 7). The average area without enhancement prior to treatment was 20 ± 35% and after treatment 61 ± 37% (p < 0.001).


CT Imaging Findings after Stereotactic Radiotherapy for Liver Tumors.

Brook OR, Thornton E, Mendiratta-Lala M, Mahadevan A, Raptopoulos V, Brook A, Najarian R, Sheiman R, Siewert B - Gastroenterol Res Pract (2015)

Nonenhancing area within the treated metastatic lesion over the follow-up period (each line represents an individual lesion).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4499630&req=5

fig7: Nonenhancing area within the treated metastatic lesion over the follow-up period (each line represents an individual lesion).
Mentions: There were 20 patients with 24 metastases treated in the study. The metastases were from colon cancer in 7 patients, melanoma in 4 patients, lung, breast, and pancreas carcinoma in 2 patients each, and renal, duodenal carcinomas, and carcinoid in one patient each. Patients clinical characteristics are described in Table 1. The patients were treated with mean total dose of 3400 ± 717 cGy (range 2400–4500 cGy), in median 3 (range 1–5) fractions with mean dose of 1183 ± 362 cGy (range 600–2400 cGy) per fraction. The mean lesion volume was 127  ±  152 cc, median 80 cc (range 4–524 cc). The mean lesion coverage was 95  ±  2% (range 90–99%). The average prescription isodose was 77  ±  4% (range 66–84%). All patients were previously treated with chemotherapy; however none were treated with chemotherapy during the stereotactic radiotherapy treatment. Complete response was seen in 1/25 lesions (4%), partial response in 14/25 lesions (58%), and partial response followed by local recurrence in 4/25 lesions (17%). For the patients with either complete response or partial response there was a significant difference between the volume prior to and after treatment (p = 0.02). The dynamics of the volume changes over the follow-up time can be seen in Figure 6. The area without enhancement within the treated metastatic lesion rose on the first follow-up study (15–45 days after treatment) and in most of the cases did not change significantly over the follow-up period unless a recurrence occurred (Figure 7). The average area without enhancement prior to treatment was 20 ± 35% and after treatment 61 ± 37% (p < 0.001).

Bottom Line: Partial response (>30% decrease in long diameter) was seen in 25/36 (69%) HCCs, 14/25 (58%) metastases, and 7/7 (100%) of CCCs.Conclusion.Prominent halo of delayed enhancement of the adjacent liver is frequent finding.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA.

ABSTRACT
Purpose. To study radiological response to stereotactic radiotherapy for focal liver tumors. Materials and Methods. In this IRB-approved, HIPAA-compliant study CTs of 68 consecutive patients who underwent stereotactic radiotherapy for liver tumors between 01/2006 and 01/2010 were retrospectively reviewed. Two independent reviewers evaluated lesion volume and enhancement pattern of the lesion and of juxtaposed liver parenchyma. Results. 36 subjects with hepatocellular carcinoma (HCC), 25 with liver metastases, and seven with cholangiocarcinoma (CCC) were included in study. Mean follow-up time was 5.6 ± 7.1 months for HCC, 6.4 ± 5.1 months for metastases, and 10.1 ± 4.8 months for the CCC. Complete response was seen in 4/36 (11.1%) HCCs and 1/25 (4%) metastases. Partial response (>30% decrease in long diameter) was seen in 25/36 (69%) HCCs, 14/25 (58%) metastases, and 7/7 (100%) of CCCs. Partial response followed by local recurrence (>20% increase in long diameter from nadir) occurred in 2/36 (6%) HCCs and 4/25 (17%) metastases. Liver parenchyma adjacent to the lesion demonstrated a prominent halo of delayed enhancement in 27/36 (78%) of HCCs, 19/21 (91%) of metastases, and 7/7 (100%) of CCCs. Conclusion. Sustainable radiological partial response to stereotactic radiotherapy is most frequent outcome seen in liver lesions. Prominent halo of delayed enhancement of the adjacent liver is frequent finding.

No MeSH data available.


Related in: MedlinePlus