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Published on: January 7, 2019
[Diagnosing radiation-induced liver injury in rabbit using 3.0 Tesla magnetic resonance diffusion-weighted imaging]
Tian-Ming Dong1, Lin Ma, Zhen-Hong Zhou
1Department of Radiology, PLA General Hospital, Beijing 100853, China.
Objective:
To evaluate the clinical value of magnetic resonance (MR) diffusion-weighted imaging (DWI) for diagnosing radiation-induced liver injury (RILI) and detecting changes in hepatic pathology at different post-irradiation times.
Methods:
Male New Zealand white rabbits received no irradiation (C0, control group; n = 10) or irradiation of 50 Gy/10F once every other day by virtual three dimensional conformal radiotherapy (3D-CRT) for one day (C1; n = 10), three days (C2; n = 10), two weeks (C3; n = 10), one month (C4; n = 10) or two months (C5; n = 10). One member of all groups were sacrificed for DWI examination and pathologic study on post-irradiation day 1, day 3, week 2, month 1 and month 2. The apparent diffusion coefficient (ADC) values were measured using a range of b values (50, 300, 600, 800 and 1000 s/mm2).
Results:
Hematoxylin-eosin (H-E) staining showed that livers of rabbits in the C3, C4 and C5 groups had the characteristic features of veno-occlusive disease. DWI examination showed that the irradiated livers of rabbits in C2, C3, C4 and C5 groups had significantly lower ADC values than the livers of the non-irradiated rabbits at b values of 300, 600, 800 and 1000 s/mm2 (P less than 0.05). When the b value was 600 s/mm2, the best negative correlation between ADC values and pathological stage was seen for the irradiated livers (Spearman's rank, r = -0.459, P less than 0.01). The threshold ADC value to distinguish the normal group (C0) from an irradiated group (more than or equal toC1) was 1.955 * 10-3 mm2/s at 600 s/mm2 b value. When the b value was 1000 s/mm2, the threshold ADC value to predict an irradiated group with normal H-E staining (C1) from an irradiated group with abnormal H-E staining (more than or equal toC2) was 1.5250 * 10-3 mm2/s; the ADC threshold value was 1.5150 * 10-3 mm2/s to predict groups C0-2 and groups C3-5.
Conclusion:
DWI has high sensitivity for detecting RILI at three days after irradiation with proper b values. Use of the ADC value is feasible for estimating the evolutionary process of pathological features of RILI damage. DWI may represent an important clinical tool for detection of early pathological changes in RILI.
Insights
Magnetic resonance diffusion-weighted imaging (DWI) can detect radiation-induced liver injury (RILI) as early as three days post-irradiation. Apparent diffusion coefficient (ADC) values from DWI correlate with RILI severity, aiding in early diagnosis and monitoring of hepatic pathology.
Area of Science:
- Radiology and Imaging Science
- Hepatology and Liver Disease Research
- Radiation Oncology and Therapy Effects
Context:
- Radiation-induced liver injury (RILI) is a significant complication following radiotherapy.
- Accurate and early detection of RILI is crucial for patient management and treatment planning.
- Current diagnostic methods may have limitations in sensitivity and timeliness.
Purpose:
- To assess the diagnostic value of magnetic resonance (MR) diffusion-weighted imaging (DWI) for RILI.
- To evaluate DWI's ability to detect hepatic pathological changes at various post-irradiation intervals.
- To correlate apparent diffusion coefficient (ADC) values with RILI severity and progression.
Summary:
- Male New Zealand white rabbits were subjected to varying doses and durations of radiation therapy.
- DWI and histopathological analyses were performed at different time points post-irradiation.
- Significantly lower ADC values were observed in irradiated livers, correlating with pathological findings of veno-occlusive disease.
Impact:
- DWI demonstrates high sensitivity for detecting RILI within three days of irradiation.
- ADC values derived from DWI are feasible for estimating the progression of RILI pathology.
- DWI shows promise as a valuable clinical tool for early detection of radiation-induced hepatic changes.
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