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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

49-year-old female patient with melanoma. In the CT scan performed 3 months after treatment a hypodensity (arrowheads) around the treated lesion (arrows) is seen. Of note, a radiopaque fiducial seed is seen laterally to the lesion.
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fig9: 49-year-old female patient with melanoma. In the CT scan performed 3 months after treatment a hypodensity (arrowheads) around the treated lesion (arrows) is seen. Of note, a radiopaque fiducial seed is seen laterally to the lesion.

Mentions: Liver surrounding the treated lesion was hyperdense to relative adjacent normal liver in 21 lesions (88%) and isodense to the surrounding liver in 3 lesions (12%), with examples shown in Figure 8. In all cases prior to treatment the liver around the lesion was isodense to the rest of the liver parenchyma. High attenuation of the adjacent liver parenchyma was seen on all postcontrast phases but was most prominent at the delayed phase. Appearance of the liver parenchyma after treatment was significantly different from before treatment (p < 0.001). Hypodense halo around the lesion was seen initially in 3/24 cases on the first follow-up (3 or less months after treatment), with change to hyperdense halo on further follow-up studies (Figure 9). If high attenuation of adjacent liver parenchyma was noted, then it was present on all follow-up studies.


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)

49-year-old female patient with melanoma. In the CT scan performed 3 months after treatment a hypodensity (arrowheads) around the treated lesion (arrows) is seen. Of note, a radiopaque fiducial seed is seen laterally to the lesion.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig9: 49-year-old female patient with melanoma. In the CT scan performed 3 months after treatment a hypodensity (arrowheads) around the treated lesion (arrows) is seen. Of note, a radiopaque fiducial seed is seen laterally to the lesion.
Mentions: Liver surrounding the treated lesion was hyperdense to relative adjacent normal liver in 21 lesions (88%) and isodense to the surrounding liver in 3 lesions (12%), with examples shown in Figure 8. In all cases prior to treatment the liver around the lesion was isodense to the rest of the liver parenchyma. High attenuation of the adjacent liver parenchyma was seen on all postcontrast phases but was most prominent at the delayed phase. Appearance of the liver parenchyma after treatment was significantly different from before treatment (p < 0.001). Hypodense halo around the lesion was seen initially in 3/24 cases on the first follow-up (3 or less months after treatment), with change to hyperdense halo on further follow-up studies (Figure 9). If high attenuation of adjacent liver parenchyma was noted, then it was present on all follow-up studies.

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