Purpose: To characterize and quantitatively assess focal radiation reactions in the liver after stereotactic single-dose radiotherapy for liver malignancies. Methods and Materials: A total of 131 multiphasic CT scans were performed in 36 patients before and after stereotactic radiotherapy for liver tumors. The examination protocol included a nonenhanced scan and contrast-enhanced scans at different times after contrast injection. The volume of the reaction was determined in each scan and the threshold dose calculated using the dose-volume histogram of the treatment plan. Results: Every patient showed a focal radiation reaction on at least one follow-up examination. In 74% of the posttherapeutic scans, a sharply demarcated hypodense area surrounded the treated tumor in the nonenhanced scans. The reaction occurred at a median of 1.8 months (range 1.2-4.6) after radiotherapy. The median threshold dose was 13.7 Gy (range 8.9=19.2). The threshold dose strongly correlated with the time of detection after therapy (r = 0.7). Radiologically, three reaction types were found on the enhanced scans: type 1, portal-venous phase: hypodense and late phase: isodense; type 2, portal-venous phase: hypodense and late phase: hyperdense; and type 3, portal-venous phase: isodense/hyperdense and late phase: hyperdense. Type 1 or 2 reactions were observed significantly earlier than type 3 (p <0.05). The median threshold dose for type 1 or 2 reactions was significantly lower than for type 3 (p <0.05). The reaction volume decreased with longer follow-up (2-4 months: median 40% of initial volume). The reaction types shifted with follow-up: 58% were of type 1 at the initial manifestation and 58% were of type 3 at the next examination thereafter. Conclusion: A focal radiation reaction occurs after stereotactic single-dose therapy in the liver. The volume of the reaction decreases and changes its radiologic appearance during follow-up. This reaction has to be differentiated from recurrent tumor. (C) 2003 Elsevier Inc.
|Data di pubblicazione:||2003|
|Titolo:||Assessment of focal liver reaction by multiphasic CT after stereotactic single-dose radiotherapy of liver tumors|
|Autore/i:||Herfarth, Kk; Hof, H; Bahner, Ml; Lohr, F; Hoss, A; Van Kaick, G; Wannenmacher, M; Debus, J|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1016/S0360-3016(03)00586-8|
|Codice identificativo ISI:||WOS:000185315200018|
|Codice identificativo Scopus:||2-s2.0-0041881997|
|Codice identificativo Pubmed:||12957256|
|Citazione:||Assessment of focal liver reaction by multiphasic CT after stereotactic single-dose radiotherapy of liver tumors / Herfarth, Kk; Hof, H; Bahner, Ml; Lohr, F; Hoss, A; Van Kaick, G; Wannenmacher, M; Debus, J. - In: INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS. - ISSN 0360-3016. - 57:2(2003), pp. 444-451.|
|Tipologia||Articolo su rivista|
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