TY - JOUR
T1 - Evaluation of Pretreatment Magnetic Resonance Elastography for the Prediction of Radiation-Induced Liver Disease
AU - Mullikin, Trey C.
AU - Pepin, Kay M.
AU - Evans, Jaden E.
AU - Venkatesh, Sudhakar K.
AU - Ehman, Richard L.
AU - Merrell, Kenneth W.
AU - Haddock, Michael G.
AU - Harmsen, William S.
AU - Herman, Michael G.
AU - Hallemeier, Christopher L.
N1 - Funding Information:
Sources of support: This study was supported with CTSA Grant UL1 TR002377 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH). Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NIH. Additional support provided by NIH Grant EB001981, U.S. Department of Defense Grant W81XWH-19-1-0583-01, and Varian Medical Systems.
Publisher Copyright:
© 2021 The Author(s)
PY - 2021/11/1
Y1 - 2021/11/1
N2 - Purpose: Magnetic resonance (MR) elastography (E) is a noninvasive technique for quantifying liver stiffness (LS) for fibrosis. This study evaluates whether LS is associated with risk of developing radiation-induced liver disease (RILD) in patients receiving liver-directed radiation therapy (RT). Methods and Materials: Based on prior studies, LS ≤3 kPa was considered normal and LS >3.0 kPa as representing fibrosis. RILD was defined as an increase in Child-Pugh (CP) score of ≥2 from baseline within 1 year of RT. Univariate and multivariate Cox models were used to assess correlation. Results: One hundred two patients, 51 with primary liver tumors and 51 with liver metastases, were identified with sufficient follow-up. In univariate models, pre-RT LS >3.0 kPa (hazard ratio [HR] 4.9; 95% confidence interval [CI], 1.6-14; P =.004), body mass index (BMI), clinical cirrhosis, CP score, albumin-bilirubin (ALBI) grade 2, primary liver tumor, and mean liver dose were significantly associated with risk of post-RT RILD. In a multivariate analysis, LS >3.0 and mean liver dose both were significantly associated with RILD risk. Conclusions: Elevated pre-RT LS is associated with an increased risk of RILD in patients receiving liver-directed RT.
AB - Purpose: Magnetic resonance (MR) elastography (E) is a noninvasive technique for quantifying liver stiffness (LS) for fibrosis. This study evaluates whether LS is associated with risk of developing radiation-induced liver disease (RILD) in patients receiving liver-directed radiation therapy (RT). Methods and Materials: Based on prior studies, LS ≤3 kPa was considered normal and LS >3.0 kPa as representing fibrosis. RILD was defined as an increase in Child-Pugh (CP) score of ≥2 from baseline within 1 year of RT. Univariate and multivariate Cox models were used to assess correlation. Results: One hundred two patients, 51 with primary liver tumors and 51 with liver metastases, were identified with sufficient follow-up. In univariate models, pre-RT LS >3.0 kPa (hazard ratio [HR] 4.9; 95% confidence interval [CI], 1.6-14; P =.004), body mass index (BMI), clinical cirrhosis, CP score, albumin-bilirubin (ALBI) grade 2, primary liver tumor, and mean liver dose were significantly associated with risk of post-RT RILD. In a multivariate analysis, LS >3.0 and mean liver dose both were significantly associated with RILD risk. Conclusions: Elevated pre-RT LS is associated with an increased risk of RILD in patients receiving liver-directed RT.
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U2 - 10.1016/j.adro.2021.100793
DO - 10.1016/j.adro.2021.100793
M3 - Article
AN - SCOPUS:85119962010
SN - 2452-1094
VL - 6
JO - Advances in Radiation Oncology
JF - Advances in Radiation Oncology
IS - 6
M1 - 100793
ER -