Long-term characterization of MRI-morphologic alterations after active motion-compensated liver SBRT

• Verfasst von: Dreher, Constantin [VerfasserIn]
• Verfasst von: Sarria, Gustavo R. [VerfasserIn]
• Verfasst von: Miebach, Georgia [VerfasserIn]
• Verfasst von: Weiß, Christel [VerfasserIn]
• Verfasst von: Bürgy, Daniel [VerfasserIn]
• Verfasst von: Wojtal, Paulina [VerfasserIn]
• Verfasst von: Tavakoli, Andrej [VerfasserIn]
• Verfasst von: Krug, David [VerfasserIn]
• Verfasst von: Oppitz, Hans [VerfasserIn]
• Verfasst von: Giordano, Frank Anton [VerfasserIn]
• Verfasst von: Both, Marcus [VerfasserIn]
• Verfasst von: Lohr, Frank [VerfasserIn]
• Verfasst von: Dunst, Jürgen [VerfasserIn]
• Verfasst von: Blanck, Oliver [VerfasserIn]
• Verfasst von: Boda-Heggemann, Judit [VerfasserIn]
• Titel: Long-term characterization of MRI-morphologic alterations after active motion-compensated liver SBRT
• Titelzusatz: a multi-institutional pooled analysis
• Verf.angabe: Constantin Dreher, Gustavo R. Sarria, Georgia Miebach, Christel Weiss, Daniel Buergy, Paulina Wojtal, Anoshirwan A. Tavakoli, David Krug, Hans Oppitz, Frank A. Giordano, Marcus Both, Frank Lohr, Jürgen Dunst, Oliver Blanck and Judit Boda-Heggemann
• E-Jahr: 2023
• Jahr: 05 Apr 2023
• Umfang: 9 S.
• Illustrationen: Illustrationen
• Fussnoten: Gesehen am 23.07.2024
• Titel Quelle: Enthalten in: Acta oncologica
• Ort Quelle: Abingdon : Taylor & Francis Group, 1987
• Jahr Quelle: 2023
• Band/Heft Quelle: 62(2023), 3 vom: Apr., Seite 281-289
• ISSN Quelle: 1651-226X
• DOI: doi:10.1080/0284186X.2023.2187707
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: healthy tissue response
• Sach-SW: liver
• Sach-SW: metastases
• Sach-SW: MRI
• Sach-SW: SBRT
• K10plus-PPN: 1896035426

Abstract

Stereotactic body radiotherapy (SBRT) is an effective therapeutic approach in patients with liver metastases. However, long-term changes in hepatic normal tissue have to be taken into account in multimodal treatment regimes. Magnetic-resonance-imaging (MRI) based morphologic liver alterations (MMA) after liver SBRT have been analyzed longitudinally. 57 patients treated with gantry-based or robotic-based SBRT of 69 treatment volumes of liver metastases, who had long-term follow-up (FU) ≥6 months were included in this retrospective analysis. Post-SBRT MMAs were contoured on each contrast-enhanced-T1-weighted (T1w) MRI-sequence. Morphologic/volumetric data of the liver and MMAs were evaluated longitudinally, including the dependency on treatment-related factors of the planning target volume (PTV) and liver. The median FU time was 1 year [6-48 months]. 66 of 69 treatment volumes developed MMAs (mean 143.8 ± 135.1 ccm at first appearance). 31.8% of MMAs resolved completely during FU. Of the persisting MMAs 82.2%/13.3% decreased/increased in size until last available FU. Morphological characterization of the MMAs at first appearance included 75% hypointense and 25% hyperintense T1w-MRI-based appearances. Hypointense as compared to hyperintense appearance was significantly associated with a higher mean liver dose EQD2α/β=3 Gy (p = 0.0212) and non-significantly greater MMA size. Variance analysis demonstrated a significant reduction of MMA and total liver volume after SBRT (p < 0.0001). The volume reduction decelerated longitudinally for both MMA (p < 0.0001) and liver size (p = 0.0033). Radiation doses (PTV-BEDα/β=3 Gy and 10 Gy) were not significantly associated with MMA volume reduction. SBRT of liver metastases with mean liver dose EQD2α/β=3 Gy > 18 Gy were characterized by greater MMA volumes (p = 0.0826) and steeper MMA reduction gradients during FU than those with EQD2α/β=3 Gy ≤ 18 Gy (p < 0.0001). Radiogenic MMAs either completely resolve or usually decrease in volume with pronounced reduction during short-term FU. This course was independent of the MMA’s morphological appearance. Further, increased mean liver dose was associated with greater MMA size and a greater gradient of MMA size reduction during FU.