Superparamagnetic iron oxide-enhanced MRI-guided stereotactic ablative radiation therapy for liver metastasis
Abstract
BACKGROUND: MRI-guided radiation therapy can image a target and irradiate it at the same time. Superparamagnetic iron oxide (SPIO) is a liver-specific contrast agent that can selectively visualize liver tumors, even if plain MRI does not depict them. The purpose of this study was to present a proof of concept of SPIO-enhanced MRI-guided radiation therapy for liver tumor.
CASE PRESENTATION: MRI-guided stereotactic ablative radiation therapy (SABR) was planned for a patient with impaired renal function who developed liver metastases after nephroureterectomy for ureteral cancer. Because liver metastasis was not visualized on plain MRI, SPIO-enhanced MRI was performed at 0.35 T using true fast imaging with steady-state free precession (true FISP) pulse sequence and SABR was performed. Liver metastasis was clearly visualized by SPIO-enhanced MRI, and MRI-guided SABR was performed without adverse events.
CONCLUSION: Even if liver metastasis is not visualized by plain MRI, liver metastasis can be clearly depicted by administering SPIO, and MRI-guided radiation therapy can be performed.
Keywords: image-guided radiation therapystereotactic radiation therapycontrast mediamagnetic resonance imagingsteady-state free precession MRI
References
- Loehrer PJ, Einhorn LH, Elson PJ, et al. A randomized comparison of cisplatin alone or in combination with methotrexate, vinblastine, and doxorubicin in patients with metastatic urothelial carcinoma: a cooperative group study. J Clin Oncol. 1992; 10(7): 1066–1073.
- Mullerad M, Russo P, Golijanin D, et al. Bladder cancer as a prognostic factor for upper tract transitional cell carcinoma. J Urol. 2004; 172(6 Pt 1): 2177–2181.
- Onderdonk BE, Gutiontov SI, Chmura SJ. The Evolution (and Future) of Stereotactic Body Radiotherapy in the Treatment of Oligometastatic Disease. Hematol Oncol Clin North Am. 2020; 34(1): 307–320.
- Lievens Y, Guckenberger M, Gomez D, et al. Defining oligometastatic disease from a radiation oncology perspective: An ESTRO-ASTRO consensus document. Radiother Oncol. 2020; 148: 157–166.
- van de Lindt TN, Fast MF, van Kranen SR, et al. MRI-guided mid-position liver radiotherapy: Validation of image processing and registration steps. Radiother Oncol. 2019; 138: 132–140.
- Wojcieszynski AP, Rosenberg SA, Brower JV, et al. Gadoxetate for direct tumor therapy and tracking with real-time MRI-guided stereotactic body radiation therapy of the liver. Radiother Oncol. 2016; 118(2): 416–418.
- Erdoğan MA, Apaydin M, Armagan G, et al. Evaluation of toxicity of gadolinium-based contrast agents on neuronal cells. Acta Radiol. 2021; 62(2): 206–214.
- Chehabeddine L, Al Saleh T, Baalbaki M, et al. Cumulative administrations of gadolinium-based contrast agents: risks of accumulation and toxicity of linear vs macrocyclic agents. Crit Rev Toxicol. 2019; 49(3): 262–279.
- Endrikat JS, Dohanish S, Balzer T, et al. Safety of gadoxetate disodium: Results from the clinical phase II-III development program and postmarketing surveillance. J Magn Reson Imaging. 2015; 42(3): 634–643.
- Lauenstein T, Ramirez-Garrido F, Kim YH, et al. Nephrogenic systemic fibrosis risk after liver magnetic resonance imaging with gadoxetate disodium in patients with moderate to severe renal impairment: results of a prospective, open-label, multicenter study. Invest Radiol. 2015; 50(6): 416–422.
- Reimer P, Balzer T. Ferucarbotran (Resovist): a new clinically approved RES-specific contrast agent for contrast-enhanced MRI of the liver: properties, clinical development, and applications. Eur Radiol. 2003; 13(6): 1266–1276.
- Wang YXJ. Current status of superparamagnetic iron oxide contrast agents for liver magnetic resonance imaging. World J Gastroenterol. 2015; 21(47): 13400–13402.