Japanese Journal of Radiology

, Volume 36, Issue 9, pp 559–565 | Cite as

Normal liver tissue change after proton beam therapy

  • Nobuyoshi Fukumitsu
  • Shinsei Takahashi
  • Toshiyuki Okumura
  • Toshiki Ishida
  • Keiko Nemoto Murofushi
  • Kayoko Ohnishi
  • Teruhito Aihara
  • Hitoshi Ishikawa
  • Koji Tsuboi
  • Hideyuki Sakurai
Original Article



Normal liver tissue changes after proton beam therapy (PBT) were investigated in patients at 1 and 2 years after the therapy.

Materials and methods

Changes in normal liver tissue volume were examined. The dose distribution of the normal liver tissue was also simulated on the follow-up CTs.


The normal liver tissue volume was 1149 ± 215 cm3 before treatment, 1089 ± 188 cm3 at 1 year, and 1080 ± 236 cm3 at 2 years after treatment. The normal liver tissue volume was increased in 10 and decreased in 20 patients at 2 years and was smaller than that before the treatment in total (P = 0.03). The simulated volume that received more than 30 Gray equivalent [V30 (cm3)] at 1 year was 258 ± 187 cm3 and that at 2 years (244 ± 171 cm3) was smaller than that before treatment (297 ± 140 cm3) (P = 0.03).


The changes in the shape and volume of normal liver tissue are not constant, which cause a large dose distribution discrepancy in the normal liver for 2 years. Therefore, careful consideration of the dose distribution of normal liver tissue is required when planning re-irradiation.


Image registration Liver Proton beam therapy HCC 



This study was partially supported by Grants-in-Aid for Scientific Research in Japan (No. 17H04256 and 16K10383). We really appreciate Flaminia Miyamasu, Medical English Communications Center, University of Tsukuba, for grammatical revision of the manuscript.

Compliance with ethical standards

Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethical statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee.


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Copyright information

© Japan Radiological Society 2018

Authors and Affiliations

  • Nobuyoshi Fukumitsu
    • 1
  • Shinsei Takahashi
    • 1
  • Toshiyuki Okumura
    • 1
  • Toshiki Ishida
    • 1
  • Keiko Nemoto Murofushi
    • 1
  • Kayoko Ohnishi
    • 1
  • Teruhito Aihara
    • 1
  • Hitoshi Ishikawa
    • 1
  • Koji Tsuboi
    • 1
  • Hideyuki Sakurai
    • 1
  1. 1.Proton Medical Research Center, University of TsukubaTsukubaJapan

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