Aims and objectives
Selective internal radiation therapy (SIRT) is a minimally invasive procedure in the treatment of malignant,
non-operable hepatic tumours using microspheres loaded with 90-yttrium delivered directly into tumour-feeding hepatic arteries by an interventional radiologist .
As the use of SIRT in the treatment of primary as well as secondary liver tumours increases,
there is an increased need to standardise and optimise the therapy in order to make it more efficient.
The main objective in SIRT is to apply a curative,
targeted dose to the tumour while...
Methods and materials
Hepatic Gd-EOB-DTPA-enhanced late phase MRI scans of 38 patients consecutively registered for SIRT with unresectable primary or secondary liver-tumours were obtained as part of the clinical routine pre-SIRT protocol.
Volumetry of liver and tumour tissues in both liver lobes performed routinely by an expert radiologist (with 20 years of experience of abdominal imaging) for SIRT (SIR-Spheres®; Sirtex Medical Limited,
Australia) dose calculation were compared to volumes segmented by a novice radiology resident.
Volumetries were done using the interactive contouring software EclipseTM(Varian Medical Systems).
The average left and right liver lobes as measured by the expert were 652.32cc and 1314.61cc,
respectively and those measured by the novice were 703.19cc and 1309.39cc,
We calculated the total average liver volume by the expert to equal 1966.9cc and 2011.6cc by the novice,
constituting an absolute mean difference of 4.3%.
The average tumour volumes in the left and right lobes as measured by the expert were 106.62cc and 300.26cc,
The novice measured an average tumour volume of 130.90cc and 341.51cc in...
Our study showed good correlations in computer-assisted interactive segmentation of liver volumes between experienced and inexperienced observers,
whereas the segmentation of liver tumours showed lower agreement.
The average tumour to liver volume calculated by the expert as well as the novice were 18.1% and 20.4%,
both below the maximum recommended tumour-load of 50% in patients considered for SIRT .
We conclude that with adequate interactive segmentation tools,
liver volumetry can be effectively performed by a novice; however,
the accurate identification and segmentation of liver tumours...
Department of Radiology
Städtisches Klinikum Dresden- Friedrichstadt
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