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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Liver magnetic resonance imaging for evaluation of response to treatment after stereotactic body radiation therapy of hepatocellular carcinoma
Alessandro Serafini, Valeria Ruggeri, Riccardo Inchingolo, Marco Gatti, Alessia Guarneri, Cesare Maino, Davide Ippolito, Luigi Grazioli, Umberto Ricardi, Riccardo Faletti
Alessandro Serafini, Marco Gatti, Riccardo Faletti, Department of Surgical Sciences, University of Turin, Turin 10126, Italy
Valeria Ruggeri, Department of Radiology, University of Brescia, Brescia 25123, Italy
Riccardo Inchingolo, Interventional Radiology Unit, Miulli Hospital, Acquaviva Delle Fonti 70124, Italy
Alessia Guarneri, Umberto Ricardi, Department of Oncology-Radiation Oncology, University of Turin, Turin 10126, Italy
Cesare Maino, Davide Ippolito, Department of Diagnostic Radiology, University of Milano-Bicocca, Monza 20900, Italy
Luigi Grazioli, Department of Radiology, Spedali Civili, University of Brescia, Brescia 25023, Italy
Author contributions: All authors equally contributed to this paper with conception and design of the study, literature review and analysis, manuscript drafting, critical revision, and editing, and approval of the final version.
Institutional review board statement: This retrospective observational study was previously approved by the Intercompany Ethics Committee of the City of Health and Science of Turin.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All the authors are aware of the content of the manuscript and have no conflict of interest to disclose.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at riccardoin@hotmail.it. Consent was not obtained but the presented data are anonymized and risk of identification is low.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Riccardo Inchingolo, MD, Chief Doctor, Director, Doctor, Interventional Radiology Unit, Miulli Hospital, Strada per Santeramo, Acquaviva Delle Fonti 70124, Italy. riccardoin@hotmail.it
Received: April 7, 2022
Peer-review started: April 7, 2022
First decision: May 29, 2022
Revised: June 24, 2022
Accepted: August 14, 2022
Article in press: August 14, 2022
Published online: September 27, 2022
ARTICLE HIGHLIGHTS
Research background
Although stereotactic body radiation therapy (SBRT) is increasingly used, its application has not yet been regulated by the main international guidelines, leaving the decision to multidisciplinary teams.
Research motivation
Literature is lacking in works assessing the role of liver magnetic resonance imaging (MRI) in the evaluation of hepatocellular carcinoma (HCC) treated by SBRT.
Research objectives
To analyse MRI features of HCC lesions treated by SBRT and monitor how these properties evolve over time and how these aspects may modify subsequent diagnostic course of therapy.
Research methods
A retrospective observational study was conducted in 49 patients (mean age 64.44 years, range 48.71-84.51), 22 females and 27 males, undergoing radiotherapy between January 2013 and November 2019.
Research results
The most significant results came from the evaluation of infield and outfield progression. The risk increased as time progressed, with a sharp increase in the cumulative outfield progression hazard of around 9 after the end of therapy, as shown by the Kaplan-Meier curve study.
Research conclusions
A multiparametric approach using a liver specific contrast agent provides more information about lesion and liver parenchyma changes compared to conventional computed tomography studies. The direct correlation between the area of hypointensity in the hepatobiliary phase and the PTV is useful to define the infield and outfield progression of the disease.
Research perspectives
Future studies should enlarge the sample of patients and perform further follow-ups for the patients who have already undergone the first two checks.
