Evaluation of early treatment response to radiotherapy for HCC using pre- and post-treatment MRI.
Evaluation of early treatment response to radiotherapy for HCC using pre- and post-treatment MRI. Acta Radiol. 2018 Oct 03;:284185118805253 Authors: Song SH, Jeong WK, Choi D, Kim YK, Park HC, Yu JI Abstract Background Stereotactic body radiation therapy is an emerging treatment option for patients with unresectable advanced hepatocellular carcinoma (HCC). Because liver parenchyma neighboring the tumor is unavoidably exposed to irradiation, evaluation of treatment response following radiotherapy for HCC is challenging due to increased peritumoral arterial hyperemia and delayed clearance of contrast agent in the tumor. Purpose To explore which change of magnetic resonance imaging (MRI) features between pre- and post-radiotherapy could help evaluate viability of HCC. Material and Methods Thirty-nine patients who underwent MRI before and immediately after radiotherapy for HCC were enrolled. Imaging features were assessed before and within three months after radiotherapy and changes of those imaging features were correlated with (i) tumor response at six months after radiotherapy and (ii) time to progression (TTP). Results On post-radiotherapy MRI, the short-term responders showed significantly higher incidence of negative typical HCC features including arterial enhancement with washout ( P = 0.032), hyper-intense T2 signal intensity ( P = 0.021), and hyper-intensity on DWI ( P
This article reviews the LR-TR algorithm; discusses locoregional therapies for HCC, treatment concepts, and expected posttreatment findings; and illustrates LI-RADS treatment response assessment with CT and MRI.
Conclusions The recent, first randomized clinical trial demonstrated overall and progression free survival benefits after SBRT to oligometastatic disease which supports prior retrospective case series (6). The spine is a common site of metastatic bone disease, and as high quality data continue to mature, along with completion of additional randomized clinical trials, it is expected that utility of SBRT to the spine will increase in the future. Spine SBRT is unique due to the requirement of sharp dose falloff to prevent serious neurologic morbidity. With recent advances in radiotherapy planning, robotic patient positionin...
Conclusion: Fat fraction on MRI corresponded to fat content on histology and therefore contributes to lesion characterization. Measurement repeatability was excellent for ADC; this parameter increased significantly post-radiotherapy even in disease categorized as stable by size criteria, and corresponded to cellularity on histology. ADC can be utilized for characterizing and assessing response in heterogeneous retroperitoneal sarcomas. Introduction Soft-tissue sarcomas are often highly heterogeneous tumors with variable components that can include cellular tumor, fat, necrosis, and cystic change. In many soft-tissue ...
Conclusions: SBRT for HCC is well-tolerated even in patients with advanced cirrhosis and prior liver-directed treatment and provides excellent LC even for larger lesions that cannot be controlled with radiofrequency ablation. LC with SBRT compares favorably to other liver-directed therapies. Prospective studies comparing SBRT with other liver-directed therapies are warranted.
To determine the natural history of imaging findings seen on magnetic resonance imaging (MRI) of hepatocellular carcinoma (HCC) treated with stereotactic body radiation therapy (SBRT). Although arterial hyperenhancement is a key feature of untreated HCC, our clinical experience suggested that tumors that never progressed could still show hyperenhancement. Therefore, we undertook a systematic study to test the hypothesis that persistent arterial phase hyperenhancement (APHE) after SBRT is an expected finding that does not suggest failure of treatment.
ConclusionHepatectomy is a common therapeutic procedure for CRLM, but CRLM with BDTT might be associated with a bad prognosis.
CONCLUSION: Hepatectomy is a common therapeutic procedure for CRLM, but CRLM with BDTT might be associated with a bad prognosis.
ConclusionCurrent practices of TACE for HCC varied widely among IRs suggesting a need for more standardized practices.
CONCLUSIONS: The incorporation of imaging findings and biological markers into NTCP modeling of liver toxicity improved the estimates of expected NTCP risk compared with using dose-only models. In addition, such generalized NTCP models should contribute to a better understanding of the normal tissue response in HCC SBRT patients and facilitate personalized treatment. PMID: 29353652 [PubMed - in process]
In this study, 20 patients with hepatocellular carcinoma were enrolled. Functional liver ti ssues were defined according to quantitative liver-spleen contrast ratios ≥ 1.5 on a hepatobiliary phase scan.