The Time Course of Dynamic Computed Tomographic Appearance of Radiation Injury to the Cirrhotic Liver Following Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma

PLoS One. 2015 Jun 11;10(6):e0125231. doi: 10.1371/journal.pone.0125231. eCollection 2015.

Abstract

This study aimed to evaluate the dynamic computed tomographic (CT) appearance of focal radiation injury to cirrhotic liver tissue around the tumor following stereotactic body radiation therapy (SBRT) for hepatocellular carcinoma (HCC). Seventy-seven patients with 92 HCCs were observed for >6 months. Sixty-four and 13 patients belonged to Child-Pugh class A and B, respectively. The median SBRT dose was 48 Gy/4fr. Dynamic CT scans were performed in non-enhanced, arterial, portal, and venous phases. The median follow-up period was 18 months. Dynamic CT appearances were classified into 3 types: type 1, hyperdensity in all enhanced phases; type 2, hypodensity in arterial and portal phases; type 3, isodensity in all enhanced phases. Half of the type 2 or 3 appearances significantly changed to type 1, particularly in patients belonging to Child-Pugh class A. After 3-6 months, Child-Pugh class B was a significant factor in type 3 patients. Thus, dynamic CT appearances were classified into 3 patterns and significantly changed over time into the enhancement group (type 1) in most patients belonging to Child-Pugh class A. Child-Pugh class B was a significant factor in the non-enhancement group (type 3).

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carcinoma, Hepatocellular / diagnostic imaging
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / surgery*
  • Female
  • Humans
  • Liver / diagnostic imaging*
  • Liver / radiation effects
  • Liver Cirrhosis / diagnostic imaging
  • Liver Cirrhosis / etiology*
  • Liver Neoplasms / diagnostic imaging
  • Liver Neoplasms / pathology
  • Liver Neoplasms / surgery*
  • Male
  • Middle Aged
  • Radiosurgery / adverse effects*
  • Radiotherapy Dosage
  • Retrospective Studies
  • Tomography, X-Ray Computed / methods*

Grants and funding

Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology of Japan (Grant no. 22591385).