Review
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World J Radiol. Aug 28, 2014; 6(8): 598-606
Published online Aug 28, 2014. doi: 10.4329/wjr.v6.i8.598
Incorporating GSA-SPECT into CT-based dose-volume histograms for advanced hepatocellular carcinoma radiotherapy
Shintaro Shirai, Morio Sato, Yasutaka Noda, Yoshitaka Kumayama, Noritaka Shimizu
Shintaro Shirai, Morio Sato, Yasutaka Noda, Yoshitaka Kumayama, Noritaka Shimizu, Department of Radiology, Wakayama Medical University, Wakayama Shi, Wakayama 641-8510, Japan
Author contributions: Shirai S, Sato M, Noda Y, Kumayama Y and Shimizu N contributed to this paper.
Correspondence to: Morio Sato, MD, Professor, Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayama Shi, Wakayama 641-8510, Japan. morisato@mail.wakayama-med.ac.jp
Telephone: +81-73-4410604 Fax: +81-73-4443110
Received: December 26, 2013
Revised: April 15, 2014
Accepted: May 28, 2014
Published online: August 28, 2014
Core Tip

Core tip: Three-dimensional conformal radiotherapy, which is designed to preserve functional liver, can be visualized by single photon emission computed tomography with Tc-99m-galactosyl human serum albumin (GSA). This treatment modality has promising therapeutic effects for hepatocellular carcinomas (HCCs) of > 14 cm in diameter that are unmanageable by proton beam therapy. A treatment plan designed to irradiate ≤ 20% of the functional liver volume (FLV20Gy≤ 20%) did not cause radiation-induced liver disease. Therefore, FLV20Gy≤ 20% may be a useful safety marker for three-dimensional radiotherapy of HCC of various sizes. It is also possible to estimate the effects of radiotherapy on the liver by dividing the GSA count in the region of the liver irradiated with ≥ 20 Gy by the GSA count of the entire liver.