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Optimizing global liver function in radiation therapy treatment planning.

Victor W Wu1, Marina A Epelman, Hesheng Wang

  • 1Department of Industrial and Operations Engineering, University of Michigan, Ann Arbor, MI 48109, USA.

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This summary is machine-generated.

Optimizing liver radiation therapy plans using liver perfusion data can significantly reduce toxicity. The Global Liver Function (GLF) model preserves more liver function compared to conventional methods, improving patient outcomes.

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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Radiotherapy Planning

Background:

  • Liver stereotactic body radiation therapy (SBRT) exhibits high toxicity variability due to differences in pre-treatment liver function and radiosensitivity.
  • Similar radiation doses can lead to disparate liver toxicity outcomes among patients.

Purpose of the Study:

  • To investigate three treatment planning optimization models for minimizing liver toxicity risk in SBRT.
  • To compare models considering pre-treatment liver function and radiosensitivity against dose-only models.

Main Methods:

  • Developed and tested three optimization models: linearized equivalent uniform dose (EUD), perfusion-weighted EUD (fEUD), and Global Liver Function (GLF).
  • Utilized voxel-based pre-treatment liver function and local-function-based radiosensitivity, incorporating dose-response relationships.
  • Computed voxel-based portal venous liver perfusion using DCE-MRI and applied models to 2D synthesized and 3D clinical cases.

Main Results:

  • The GLF model preserved up to 10% more liver function than the fEUD model in 2D cases and up to 5% in 3D cases.
  • GLF and fEUD plans showed improved functional liver dose metrics compared to the conventional EUD model.
  • Liver perfusion information during planning demonstrated potential to minimize toxicity by improving expected GLF.

Conclusions:

  • Incorporating liver perfusion data into treatment planning optimizes Global Liver Function (GLF) and minimizes toxicity risk.
  • The GLF model offers direct optimization of a clinically relevant metric, potentially improving upon fEUD and EUD plans.
  • The degree of benefit from perfusion-informed planning varies with individual liver perfusion patterns.