Hepatobiliary scintigraphy allows the evaluation of short-term functional toxicity of liver stereotactic body radiotherapy: Results of a pilot study

PLoS One. 2018 Oct 10;13(10):e0204013. doi: 10.1371/journal.pone.0204013. eCollection 2018.

Abstract

Purpose: To study the potential of (99m)Tc-Mebrofenin hepatobiliary scintigraphy (HBS) in identifying the short-term variations of liver function after stereotactic body radiotherapy (SBRT) for liver cancers.

Material and methods: We treated with SBRT 3 patients (pts) affected by a cholangiocarcinoma and 3 patient presenting liver metastases (3x15 Gy, 4 pts; 5x8 Gy, 1 pt; 6x5 Gy, 1 pt). All patients received HBS before and 3 months after SBRT, which were co-registered with the simulation CT-scan. Structures corresponding to isodoses from 10-90 Gy were created, with intervals of 10 Gy. Finally, the variations of the mean activity (MBq) in each isodose structure have been calculated. Then, a linear regression analysis was performed.

Results: We showed a linear reduction of the activity, significantly related to the delivered dose (p<0.01), and a reduction of the perfusion of 0.78% for each delivered Gy. The linear equation has predictive value of the loss of the function of 96% (R2 = 0.9605).

Conclusions: HBS could improve treatment plans for liver SBRT, by allowing the identification of the liver function variations after SBRT and, potentially, the prediction of remnant liver function after SBRT. These preliminary results should be confirmed on long-term prospective data and larger population.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aniline Compounds
  • Bile Duct Neoplasms / radiotherapy*
  • Cholangiocarcinoma / radiotherapy*
  • Dose Fractionation, Radiation
  • Female
  • Glycine
  • Humans
  • Imino Acids / administration & dosage
  • Linear Models
  • Liver Function Tests
  • Liver Neoplasms / diagnostic imaging
  • Liver Neoplasms / physiopathology
  • Liver Neoplasms / radiotherapy*
  • Liver Neoplasms / secondary*
  • Male
  • Middle Aged
  • Organotechnetium Compounds / administration & dosage
  • Pilot Projects
  • Prospective Studies
  • Radionuclide Imaging / methods*
  • Radiosurgery / adverse effects*
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Aniline Compounds
  • Imino Acids
  • Organotechnetium Compounds
  • technetium Tc 99m mebrofenin
  • Glycine

Grants and funding

The authors received no specific funding for this work.