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01-09-2016 | Original Article

MRI morphologic alterations after liver SBRT

Direct dose correlation with intermodal matching

Authors: Judit Boda-Heggemann, MD PhD, Ulrike Attenberger, MD, Johannes Budjan, MD, Anika Jahnke, PhD, Lennart Jahnke, PhD, Lena Vogel, Anna O. Simeonova-Chergou, MD, Carsten Herskind, PhD, Frederik Wenz, MD, Frank Lohr, MD

Published in: Strahlentherapie und Onkologie | Issue 9/2016

Abstract

Aim

CT morphologic and histopathologic alterations have been reported after SBRT. We analyzed the correlation of MRI morphologic alterations with radiation doses to assess the potential for MRI-based dose–effect correlation in healthy liver tissue.

Patients and methods

MRI data of 24 patients with liver metastases 7±3 weeks after image-guided SBRT in deep-inspiration breath-hold were retrospectively analyzed. MRI images were intermodally matched to the planning CT and corresponding dose distribution. Absolute doses were converted to EQD_2,α/β =x with α/β values of 2, 3 for healthy liver tissue, 8 Gy for modelled predamaged liver tissue and 10 Gy for tumor tissue.

Results

A central nonenhancing area was observed within the isodose lines of nominally 48.2 ± 15.2 Gy, EQD_{2Gy/α/β =10} 92.5 ± 27.7 Gy. Contrast-enhancement around the central nonenhancing area was observed within the isodose lines of nominally 46.9 ± 15.3 Gy, EQD_{2Gy/α/β =10} 90.5 ± 28.3 Gy.

Outside the high-dose volume, in the beam path, characteristic sharply defined, nonblurred MRI morphologic alterations were observed that corresponded with the following isodose lines: T1-intensity changes occurred at isodose lines of nominally 21.9 ± 6.7 Gy (EQD_2,α/β =2 42.5 ± 8.7 Gy, EQD_2,α/β =3 38.5 ± 7.6 Gy, EQD_2,α/β =830.2 ±6.3 Gy). T2-hyper/hypointensity was observed within isodose lines of nominally 22.4 ± 6.6 Gy (EQD_2,α/β=2 42.7 ± 8.1 Gy, EQD_2,α/β=3 38.7 ± 7 Gy; EQD_2,α/β=8 30.5 ± 5.9 Gy).

Conclusions

Using deformable matching, direct spatial/dosimetric correlation of SBRT-induced changes in liver tissue was possible. In the PTV high-dose region, a central nonenhancing area and peripheral contrast medium accumulation was observed. Beam path doses of 38–42 Gy (EQD_{2,α/β =2–3}) induce characteristic MRI morphologic alterations.

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Title: MRI morphologic alterations after liver SBRT
Direct dose correlation with intermodal matching
Authors: Judit Boda-Heggemann, MD PhD
Ulrike Attenberger, MD
Johannes Budjan, MD
Anika Jahnke, PhD
Lennart Jahnke, PhD
Lena Vogel
Anna O. Simeonova-Chergou, MD
Carsten Herskind, PhD
Frederik Wenz, MD
Frank Lohr, MD
Publication date: 01-09-2016
Publisher: Springer Berlin Heidelberg
Published in: Strahlentherapie und Onkologie / Issue 9/2016
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-016-1013-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

MRI morphologic alterations after liver SBRT

Direct dose correlation with intermodal matching

Abstract

Aim

Patients and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Aim

Patients and methods

Results

Conclusions

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