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Published online before print February 5, 2004, 10.1148/radiol.2303021183
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(Radiology 2004;230:753-760.)
© RSNA, 2004

Experimental Studies

Intraoperative Radiation Therapy in Liver Tissue in a Pig Model: Monitoring with Dual-Modality PET/CT1

Gerald Antoch, MD, Gernot M. Kaiser, MD, Andrea B. Mueller, MD, Klaus A. Metz, MD, Hongwei Zhang, MD, Hilmar Kuehl, MD, Stephanie Westermann, Christoph E. Broelsch, MD, Stefan P. Mueller, MD, Andreas Bockisch, MD, PhD and Jörg F. Debatin, MD, MBA

1 From the Depts of Diagnostic and Interventional Radiology (G.A., H.K., J.F.D.), General and Transplantation Surgery (G.M.K., H.Z., S.W., C.E.B.), Radiation Therapy (A.B.M.), Pathology (K.A.M.), and Nuclear Medicine (S.P.M., A.B.); and Institute of Medical Physics (A.B.), Univ Hosp Essen, Hufelandstrasse 55, 45127 Essen, Germany. Received Sep 24, 2002; revision requested Nov 26; final revision received Jul 21, 2003; accepted Aug 6. Address correspondence to G.A. (e-mail: gerald.antoch@uni-essen.de).

PURPOSE: To assess, in a pig model, the value of dual-modality positron emission tomography (PET)/computed tomography (CT) for monitoring radiation therapy.

MATERIALS AND METHODS: Central bile duct resection followed by creation of a biliodigestive anastomosis was performed in nine pigs. Six of these pigs were also treated with intraoperative radiation therapy (IORT) (20 Gy) in the area of the anastomosis. Two, 4, and 8 weeks postoperatively, contrast material–enhanced fluorine 18 fluorodeoxyglucose (FDG) PET/CT of the liver was performed in all of the animals. The radioactive tracer concentration in the region of the anastomosis was quantified, and the values were compared intraindividually with the values at the liver periphery. Histologic evaluation of the liver was performed 8 weeks postoperatively. The PET/CT images were assessed for changes in liver volume and bile duct diameter over time.

RESULTS: In all nine pigs, the region of the anastomosis could be clearly defined on the fused PET/CT images. PET/CT revealed a decreased concentration of FDG in the irradiated field 2 and 4 weeks after IORT. At 8 weeks, however, the distribution of the tracer in the irradiated pigs did not differ from that in the nonirradiated pigs. Homogeneous tracer uptake in all liver regions was observed in the nonirradiated animals. The CT images showed an increase in liver volume in all pigs and bile duct dilatation that increased over time in the irradiated pigs.

CONCLUSION: The morphologic and functional changes due to IORT in liver tissue can be accurately monitored with dual-modality PET/CT. By enabling the integration of functional and morphologic data, PET/CT may have an important role in monitoring radiation treatment.

© RSNA, 2004

Index terms: Bile ducts, surgery • Dual-modality imaging, PET/CT, 761.12162, 761.12163, 765.12162, 765.12163 • Experimental study • Liver, CT, 761.12111, 761.12112, 761.12115 • Therapeutic radiology, intraoperative




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