Tadimalla Sirisha, Wang Wei, Haworth Annette
Institute of Medical Physics, School of Physics, Faculty of Science, The University of Sydney, Camperdown, NSW 2006, Australia.
Crown Princess Mary Cancer Centre, Sydney West Radiation Oncology Network, Western Sydney Local Health District, Sydney, NSW 2145, Australia.
Cancers (Basel). 2022 Nov 28;14(23):5860. doi: 10.3390/cancers14235860.
Stereotactic body radiation therapy (SBRT) is an emerging treatment for liver cancers whereby large doses of radiation can be delivered precisely to target lesions in 3-5 fractions. The target dose is limited by the dose that can be safely delivered to the non-tumour liver, which depends on the baseline liver functional reserve. Current liver SBRT guidelines assume uniform liver function in the non-tumour liver. However, the assumption of uniform liver function is false in liver disease due to the presence of cirrhosis, damage due to previous chemo- or ablative therapies or irradiation, and fatty liver disease. Anatomical information from magnetic resonance imaging (MRI) is increasingly being used for SBRT planning. While its current use is limited to the identification of target location and size, functional MRI techniques also offer the ability to quantify and spatially map liver tissue microstructure and function. This review summarises and discusses the advantages offered by functional MRI methods for SBRT treatment planning and the potential for adaptive SBRT workflows.
立体定向体部放射治疗（SBRT）是一种新兴的肝癌治疗方法，可将大剂量辐射精确地分3 - 5次给予靶病变。靶剂量受限于可安全给予非肿瘤肝脏的剂量，这取决于基线肝功能储备。当前肝脏SBRT指南假定非肿瘤肝脏的肝功能是均匀的。然而，由于存在肝硬化、既往化疗或消融治疗或放疗造成的损伤以及脂肪性肝病，在肝脏疾病中肝功能均匀这一假设是错误的。来自磁共振成像（MRI）的解剖学信息越来越多地用于SBRT计划。虽然其目前的应用仅限于识别靶位置和大小，但功能MRI技术还能够量化并在空间上绘制肝组织微观结构和功能图。本综述总结并讨论了功能MRI方法在SBRT治疗计划中的优势以及自适应SBRT工作流程的潜力。
