Service de Radio-oncologie, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
Service de Radio-oncologie, Centre Hospitalier Régional Universitaire « Jean Minjoz », INSERM U1098 EFS/BFC, Besançon cedex, France.
PLoS One. 2018 Oct 10;13(10):e0204013. doi: 10.1371/journal.pone.0204013. eCollection 2018.
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.
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.
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).
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.
研究^(99m)Tc-Mebrofenin 肝胆闪烁成像（HBS）在识别立体定向体放射治疗（SBRT）肝癌后肝功能短期变化中的潜力。
我们对 3 例胆管癌和 3 例肝转移患者（3x15 Gy，4 例；5x8 Gy，1 例；6x5 Gy，1 例）进行了 SBRT 治疗。所有患者均在 SBRT 前后进行 HBS 检查，并与模拟 CT 扫描进行配准。创建了从 10-90 Gy 等剂量线的结构，间隔为 10 Gy。最后，计算了每个等剂量线结构中的平均活性（MBq）的变化。然后进行线性回归分析。
我们显示出活性的线性降低，与所给予的剂量显著相关（p<0.01），并且每给予 1 Gy 的灌注减少 0.78%。线性方程对功能丧失的预测值为 96%（R2 = 0.9605）。
HBS 可以通过识别 SBRT 后肝功能的变化，并有可能预测 SBRT 后剩余肝功能，从而改善肝脏 SBRT 的治疗计划。这些初步结果应在长期前瞻性数据和更大的人群中得到证实。
