title: Hepatic volume changes after lobar selective internal radiation therapy (SIRT) of hepatocellular carcinoma.
abstract: OBJECTIVE
  To assess volume changes of treated and non-treated liver segments after selective internal radiation therapy (SIRT) in patients with hepatocellular carcinoma (HCC) and compromised hepatic function due to cirrhosis over a time course of 12 months after SIRT.
  
  
  METHODS
  All patients underwent SIRT of the right liver lobe with yttrium 90 (Y-90). Absolute volumes of the right liver lobe (RLV) and left liver lobe (LLV) were assessed using computed tomography (CT) before and 1, 3, 6, 9, and 12 months after SIRT. Changes at follow-up relative to baseline volumes were analysed ("normalized" volumes). Furthermore, the relative volume of the LLV [LLV/(RLV + LLV)] was calculated ("relative" volumes). For statistical analysis p < 0.05 was considered statistically significant.
  
  
  RESULTS
  Forty-five HCC patients (36 men, nine women, mean age 71.9 years, range 55-90 years) were studied. The mean baseline RLV and LLV reached 1116 ml [95% confidence intervals (CI): 1006-1226 ml] and 601 ml (95% CI: 514-688 ml), respectively. At 6 months following radioembolization, the LLV increased by 30.8% (RLV -33.9%), with the relative LLV increasing from 35% (pre-radioembolization) to 50.5%. RLV further decreased and LLV increased 12 months after SIRT (nRLV -44.9%, nLLV +40.1%, relative LLV 56.5%). All changes were significant.
  
  
  CONCLUSIONS
  Constraints of liver function after radioembolization of one liver lobe can be partially compensated through hypertrophy of the contralateral lobe. The rate of volumetric changes is the highest in the first 6 months following radioembolization. The present data can also be the basis to propagate radiation lobectomy for selected patients, simultaneously providing tumour control and future remnant liver hypertrophy before curative hemihepatectomy.
authors.affiliation: Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany. Electronic address: jens.theysohn@uni-due.de.
authors.forename: J M
authors.initials: JM
authors.lastname: Theysohn
authors.affiliation: Department of Gastroenterology and Hepatology, University Hospital Essen, Essen, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Ertle
authors.affiliation: Department of Nuclear Medicine, University Hospital Essen, Essen, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Müller
authors.affiliation: Department of Gastroenterology and Hepatology, University Hospital Essen, Essen, Germany.
authors.forename: J F
authors.initials: JF
authors.lastname: Schlaak
authors.affiliation: Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Nensa
authors.affiliation: Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Sipilae
authors.affiliation: Department of Nuclear Medicine, University Hospital Essen, Essen, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Bockisch
authors.affiliation: Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany.
authors.forename: T C
authors.initials: TC
authors.lastname: Lauenstein
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000532:radiotherapy*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology* / Q000528:radiation effects; D008113:Liver Neoplasms / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D015021:Yttrium Radioisotopes / Q000627:therapeutic use
chemical_list: D015021:Yttrium Radioisotopes