Effect of stereotactic body radiotherapy on regional metabolic liver function investigated in patients by dynamic [18F]FDGal PET/CT

• Published in: Radiation oncology (London, England) Vol. 16; no. 1; pp. 192 - 7
• Main Authors: Sørensen, Michael, Fode, Mette Marie, Petersen, Jørgen Baltzer, Holt, Marianne Ingerslev, Høyer, Morten
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 01.10.2021; BioMed Central; BMC
• Subjects: Ablation; Aged; Aged, 80 and over; Cancer; Care and treatment; Cholangiocarcinoma; Colorectal cancer; Colorectal carcinoma; Computed tomography; Confidence intervals; Curve fitting; D-Galactose; Development and progression; Dose-response relationship (Biochemistry); Dose-Response Relationship, Radiation; Dosimetry; Female; Fluorine isotopes; Fucose - analogs & derivatives; Fucose - pharmacokinetics; Functional imaging; Galactokinase; Galactose; Humans; Liver; Liver - diagnostic imaging; Liver - metabolism; Liver - radiation effects; Liver cancer; Liver diseases; Liver Neoplasms - metabolism; Liver Neoplasms - radiotherapy; Liver tumors; Male; Males; Medical imaging; Metabolic liver function; Metabolism; Metastases; Methods; Middle Aged; Oncology; Oncology, Experimental; Patient outcomes; Patients; Planning; Polynomials; Positron emission; Positron emission tomography; Positron Emission Tomography Computed Tomography - methods; Radiation; Radiation dosage; Radiation therapy; Radiopharmaceuticals - pharmacokinetics; Radiosurgery - adverse effects; Radiotherapy; Radiotherapy Dosage; Respiration; Software; Tissues; Tomography; Tumors; Denmark; Palo Alto California; United States > US; Galactokinase; Metabolic liver function; Liver cancer; Oncology; Functional imaging
• ISSN: 1748-717X; 1748-717X
• DOI: 10.1186/s13014-021-01909-z

Stereotactic body radiotherapy (SBRT) is increasingly used for treatment of liver tumors but the effect on metabolic liver function in surrounding tissue is largely unknown. Using 2-deoxy-2-[ F]fluoro-D-galactose ([ F]FDGal) positron emission tomography (PET)/computed tomography (CT), we aimed to determine a dose-response relationship between radiation dose and metabolic liver function as well as recovery. One male subject with intrahepatic cholangiocarcinoma and five subjects (1 female, 4 male) with liver metastases from colorectal cancer (mCRC) underwent [ F]FDGal PET/CT before SBRT and after 1 and 3 months. The dose response was calculated using the data after 1 month and the relative recovery was evaluated after 3 months. All patients had normal liver function at time of inclusion. A linear dose-response relationship for the individual liver voxel dose was seen until approximately 30 Gy. By fitting a polynomial curve to data, a mean TD of 18 Gy was determined with a 95% CI from 12 to 26 Gy. After 3 months, a substantial recovery was observed except in tissue receiving more than 25 Gy. [ F]FDGal PET/CT makes it possible to determine a dose-response relationship between radiation dose and metabolic liver function, here with a TD of 18 Gy (95% CI 12-26 Gy). Moreover, the method makes it possible to estimate metabolic recovery in liver tissue.