Liver Volume from the Point of View of Portal Flow (Normal Liver): Region Growing Method

2009 ◽  
pp. 13-15
Author(s):  
Akinari Miyazaki
Keyword(s):  
Liver Volume ◽  
Region Growing ◽  
Normal Liver ◽  
Point Of View ◽  
Portal Flow ◽  
Liver Region

Liver regeneration after radiotherapy in patients with hepatocellular carcinoma: A simple-to-use model and nomogram.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16115-e16115
Author(s):  
Ting-Shi Su ◽  
Li-Qing Li ◽  
Shi-Xiong Liang
Keyword(s):  
Hepatocellular Carcinoma ◽  
Risk Stratification ◽  
Liver Regeneration ◽  
Validation Cohort ◽  
Liver Volume ◽  
Normal Liver ◽  
Target Area ◽  
Good Prediction ◽  
Characteristic Analysis ◽  
Training Cohort

e16115 Background: In the past clinical practice of radiotherapy for liver cancer, liver regeneration (LR) which is beneficial to the prevention or recovery of radiation-induced liver injury, has not received enough attention. In current study, we aimed to build and validate multivariate model for liver regeneration after radiation therapy for hepatocellular carcinoma (HCC) based on data from 2 prospective studies. Methods: Thirty patients treated with preoperative downstaging radiotherapy were prospectively included in the training cohort, and 21 patients treated with postoperative adjuvant radiotherapy were included in the validation cohort. Liver regeneration was defined as an increase of more than 10% of normal liver volume in the areas of the protected hepatic segment or lobe, without Child-Pugh class decreased and tumor progression compared to pre-radiotherapy. Model and nomogram of liver regeneration after radiotherapy were developed and validated. The cut-off points of each optimal predictors were obtained using receiver-operating characteristic analysis. Risk stratification based on the cut-off point was conducted to compare the proportion of patients with liver regeneration between subgroups. Results: After radiotherapy, 12 (40%) cases in the training cohort and 13 (61.9%) cases in the validation cohort experienced liver regeneration. The model and nomogram of liver regeneration based on SVs20 (standard residual liver volume spared from at least 20 Gy) and alanine aminotransferase (ALT) showed good prediction performance (AUC = 0.759) in training cohort and performed well (AUC = 0.808) in the validation cohort. The risk stratification according to the cutoffs of SVs20 with 303.4 mL and ALT with 43 U/L demonstrated clear differentiation in risk of liver regeneration between the training(P = 0.049) and entire cohort (P = 0.032). The proportion of patients with liver regeneration decrease progressively with 88.9% in high-probability group (ALT＜43 U/L and SVs20＜303.4 mL), 60% in high-intermediate probability group (ALT ≥43 U/L and SVs20＜303.4 mL), 43.75% in low-intermediate probability group (ALT＜43 U/L and SVs20≥303.4 mL) and 33% in low- probability group (ALT≥43 U/L and SVs20≥303.4 mL). Conclusions: SVs20 and ALT are optimal predictors for liver regeneration. This simple-to-use nomogram is beneficial to the constraints of normal liver outside the radiotherapy target area and make prognosis-based decision without complex calculations. Clinical trial information: ChiCTR1800015350. [Table: see text]

BIOCHEMICAL EFFECTS OF IRRADIATION ON LIVER REGENERATION

1960 ◽  
Vol 38 (10) ◽  
pp. 1059-1068 ◽  
Author(s):  
D. K. Myers
Keyword(s):  
Deoxyribonucleic Acid ◽  
Normal Liver ◽  
Cell Nuclei ◽  
Local Irradiation ◽  
Biochemical Effects ◽  
Marked Accumulation ◽  
Liver Region ◽  
Rat Livers ◽  
Weight Number ◽  
Effects Of Irradiation On

Little change in the total weight, number of cell nuclei, and amounts of protein, ribonucleic acid, and deoxyribonucleic acid occurs in rat livers after local irradiation of the liver region. However, irradiation of the normal liver before partial hepatectomy does retard subsequent DNA accumulation and increase in number of cell nuclei. These effects appear to be due to a localized action of the radiation on the liver cells. The lag in DNA accumulation is not accompanied by a marked accumulation of acid-soluble purine–deoxyribose derivatives.

Repeat 90Y-microsphere radioembolization for hepatic malignancies: Safety and patient selection issues

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 15177-15177
Author(s):  
A. S. Kennedy ◽  
W. A. Dezarn ◽  
P. McNeillie ◽  
M. England ◽  
C. Overton ◽  
...  
Keyword(s):  
Liver Function ◽  
Liver Tumors ◽  
External Beam Radiotherapy ◽  
Liver Volume ◽  
Latency Period ◽  
Normal Liver ◽  
External Beam Radiation ◽  
Unknown Primary ◽  
External Beam ◽  
Beam Radiation

15177 Background: Liver tolerance to reirradiation with multiple doses of 90Y-microspheres is not known. Many patients (pts) have also received external beam radiotherapy to the liver or through the liver and are surviving long enough to be considered for a second and third liver treatments with internal radiation. Methods: The experience of a single center treating liver tumors with resin 90Y-microspheres was used. Pts that received liver radiation prior to or after resin microsphere therapy were studied. Endpoints were toxicity, tumor response, disease type, latency period between radiation treatments, shunting to lung, and effects on liver volume and function. The delivery activity of microspheres selected was not reduced below that which was typically chosen for patients without prior liver radiation which was 25% reduced from the manufacturer’s BSA dose calculation method. All patients received bilobar microsphere delivery during a single session. Results: A total of 40 pts were identified; 14 women, 26 men, treated 6/2003 to 12/2006, with 35 pts receiving 2 courses and 5 pts with 3 courses of liver radiation. Retreatment with resin microspheres 26 pts, prior external beam radiation in 7 pts, prior glass microspheres in 2pts, prior systemic radiotherapy in 2 pts, and prior stereotactic liver radiation in 1 pt. Liver function was stable and adequate in all patients after additional liver radiation, and no pts developed radiation-induced liver dysfunction (RILD) or veno-occlusive disease (VOD). The percentage of shunting to the lung decreased with retreatment. Tumors treated: 14 carcinoid, 11 colorectal, 6 hepatocellular and cholangiocarcinoma, 2 sarcoma, 3 unknown primary, 1 each of breast, esophagus, and head and neck primaries. Conclusions: Repeated radiation to the liver with 90Y-microspheres appears safe in patients that have sufficient normal liver function and reserve based on known laboratory parameters already used for selection of microsphere therapy. No acute life-threatening, fatal, or late liver damage was observed, i.e. RILD or VOD. No specific dose reduction is recommended for retreatment of the liver. No significant financial relationships to disclose.

scholarly journals A Prospective Study of Liver Regeneration After Radiotherapy Based on a New (Su’S) Target Area Delineation

2021 ◽  
Vol 11 ◽  
Author(s):  
Ting-Shi Su ◽  
Li-Qing Li ◽  
Shi-Xiong Liang ◽  
Bang-De Xiang ◽  
Jian-Xu Li ◽  
...  
Keyword(s):  
Liver Regeneration ◽  
Validation Cohort ◽  
Liver Volume ◽  
Normal Liver ◽  
Target Area ◽  
Good Prediction ◽  
Characteristic Analysis ◽  
Training Cohort ◽  
Good Prediction Performance ◽  
A Prospective Study

BackgroundIn this study, we designed a new (Su’S) target area delineation to protect the normal liver during liver regeneration and prospectively evaluate liver regeneration after radiotherapy, as well as to explore the clinical factors of liver regeneration and established a model and nomogram.MethodsThirty patients treated with preoperative downstaging radiotherapy were prospectively included in the training cohort, and 21 patients treated with postoperative adjuvant radiotherapy were included in the validation cohort. The cut-off points of each optimal predictor were obtained using receiver-operating characteristic analysis. A model and nomogram for liver regeneration after radiotherapy were developed and validated.ResultsAfter radiotherapy, 12 (40%) and 13 (61.9%) patients in the training and validation cohorts experienced liver regeneration, respectively. The risk stratification model based on the cutoffs of standard residual liver volume spared from at least 20 Gy (SVs20 = 303.4 mL/m2) and alanine aminotransferase (ALT=43 u/L) was able to effectively discriminate the probability of liver regeneration. The model and nomogram of liver regeneration based on SVs20 and ALT showed good prediction performance (AUC=0.759) in the training cohort and performed well (AUC=0.808) in the validation cohort.ConclusionsSVs20 and ALT were optimal predictors of liver regeneration. This model may be beneficial to the constraints of the normal liver outside the radiotherapy-targeted areas.

BIOCHEMICAL EFFECTS OF IRRADIATION ON LIVER REGENERATION

1960 ◽  
Vol 38 (1) ◽  
pp. 1059-1068 ◽  
Author(s):  
D. K. Myers
Keyword(s):  
Deoxyribonucleic Acid ◽  
Normal Liver ◽  
Cell Nuclei ◽  
Local Irradiation ◽  
Biochemical Effects ◽  
Marked Accumulation ◽  
Liver Region ◽  
Rat Livers ◽  
Weight Number ◽  
Effects Of Irradiation On

Little change in the total weight, number of cell nuclei, and amounts of protein, ribonucleic acid, and deoxyribonucleic acid occurs in rat livers after local irradiation of the liver region. However, irradiation of the normal liver before partial hepatectomy does retard subsequent DNA accumulation and increase in number of cell nuclei. These effects appear to be due to a localized action of the radiation on the liver cells. The lag in DNA accumulation is not accompanied by a marked accumulation of acid-soluble purine–deoxyribose derivatives.

scholarly journals Elections in Irkutsk Region: Growing Opportunities Civil Activity

2020 ◽  
Author(s):  
Ivan Shirokov ◽  
Keyword(s):  
Social Studies ◽  
Region Growing ◽  
Point Of View ◽  
Civic Activity ◽  
Irkutsk Region

The elections in the Irkutsk region are examined from the point of view of the growth of civic activity based on social studies and on the basis of published materials and facts. The significance of the transformation of traditional elective procedures and rules is reflected.

scholarly journals Portal flow modulation in living donor liver transplantation: review with a focus on splenectomy

Surgery Today ◽  
2019 ◽  
Vol 50 (1) ◽  
pp. 21-29 ◽  
Author(s):  
Tomoharu Yoshizumi ◽  
Masaki Mori
Keyword(s):  
Liver Transplantation ◽  
Living Donor ◽  
Living Donor Liver Transplantation ◽  
Current Knowledge ◽  
Liver Volume ◽  
Weight Ratio ◽  
Portal Flow ◽  
Donor Liver ◽  
Flow Modulation ◽  
Donor Liver Transplantation

Abstract Small-for-size graft (SFSG) syndrome after living donor liver transplantation (LDLT) is the dysfunction of a small graft, characterized by coagulopathy, cholestasis, ascites, and encephalopathy. It is a serious complication of LDLT and usually triggered by excessive portal flow transmitted to the allograft in the postperfusion setting, resulting in sinusoidal congestion and hemorrhage. Portal overflow injures the liver directly through nutrient excess, endothelial activation, and sinusoidal shear stress, and indirectly through arterial vasoconstriction. These conditions may be attenuated with portal flow modulation. Attempts have been made to control excessive portal flow to the SFSG, including simultaneous splenectomy, splenic artery ligation, hemi-portocaval shunt, and pharmacological manipulation, with positive outcomes. Currently, a donor liver is considered a SFSG when the graft-to-recipient weight ratio is less than 0.8 or the ratio of the graft volume to the standard liver volume is less than 40%. A strategy for transplanting SFSG safely into recipients and avoiding extensive surgery in the living donor could effectively address the donor shortage. We review the literature and assess our current knowledge of and strategies for portal flow modulation in LDLT.

scholarly journals RELATION OF THE PORTAL BLOOD TO LIVER MAINTENANCE

1920 ◽  
Vol 31 (5) ◽  
pp. 609-632 ◽  
Author(s):  
Peyton Rous ◽  
Louise D. Larimore
Keyword(s):  
Normal Liver ◽  
Compensatory Hypertrophy ◽  
The Body ◽  
Portal Blood ◽  
Portal System ◽  
Hepatic Tissue ◽  
Similar Degree ◽  
Portal Flow ◽  
Tissue Replacement ◽  
Large Bulk

The occlusion of portal branches to a part of the liver of the rabbit leads to a progressive and ultimately complete atrophy of the parenchyma in the region deprived of portal blood, and to hypertrophy of the rest of the hepatic tissue which receives such blood in excess. Three-fourths of the liver may thus be reduced to a fibrous tag within 2 months, while the remaining fourth attains the bulk of the entire original organ. The atrophy is simple, unaccompanied by obvious degenerative changes or by any connective tissue replacement. More important, it is conditional in nature, failing to progress when the bile duct from the proliferating tissue is ligated and its hypertrophy checked in this way. There are indications in the literature that an atrophy conditional on hypertrophy, such as is here described, occurs in man after local portal occlusion. And some experiments in our laboratory, not yet completed, show definitely its occurrence in the dog. The changes take place slowly in the canine liver. After 3 months the tissue deprived of portal blood has diminished to about one-third of its original bulk. The conditional character of the atrophy is proven by its failure to occur to any similar degree in the absence of a compensating parenchyma, as when the portal stream is diverted from the whole liver by way of an Eck fistula. Is the atrophy functional? If so, its completeness would indicate that the liver has no essential activity—none on which its maintenance depends—that it is not intimately connected with substances derived from organs drained by the portal system. Observations on the rate of hypertrophy after local diversion of the portal stream and on the character of the bile secreted by the atrophic tissue may be taken to favor such a view. The hypertrophy is nearly, perhaps quite, as rapid as if the tissue deprived of portal blood had been removed from the body. The bile secreted from a liver mass far advanced in atrophy and competing with a large bulk of parenchyma that receives the entire portal stream is almost colorless and may give but a weak Pettenkofer reaction. Glycogen, on the other hand, is present in the atrophic cells in approximately the same amount and distribution as in the hypertrophic liver tissue of the same animal. The fact that a parenchymal shift follows local disturbances in the portal stream has a bearing on the cause of certain alterations in the shape of the normal liver that have been loosely attributed heretofore to pressure from the surrounding organs. It also has some interest in connection with pathological changes. Liver hypertrophy dependent on a preceding destruction has long been known to pathologists. Now a type of destruction dependent on compensatory hypertrophy must also be reckoned with. The occurrence of changes of the latter character will explain certain of the lesions observed in diseases that involve a disturbance of the portal flow to portions of the liver substance.

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