{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T01:49:18Z","timestamp":1762048158213,"version":"build-2065373602"},"reference-count":15,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,4,25]],"date-time":"2022-04-25T00:00:00Z","timestamp":1650844800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Grant-in-Aid for Scientific Research on Innovative Areas (KAKENHI)","award":["16K10289"],"award-info":[{"award-number":["16K10289"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>We studied five pathological specimens from five patients at 1.5, 3.0, 4.0, 13.5, and 14.0 months after radiotherapy for HCC. Four needle biopsies were obtained to investigate liver parenchyma of focal liver reaction (FLR) around treated HCC, when patients had newly developed HCC or local recurrence appeared in the liver. Liver resection was performed in one case where insufficient radiotherapy effect for HCC was suspected. In all patients, FLR was recognized as a hypervascular area around the HCC on enhanced CT and enhanced Gd-EOB-DTPA (EOB-MRI). Liver specimens were analyzed to assess the pathological characteristics of FLR. FLR was recognized as prolonged liver enhancement in enhanced CT and EOB-MRI. From pathological understanding, sinusoidal dilatation with degeneration and desquamation was caused by direct endothelial cell injury following radiotherapy. Hepatocytes and endothelium fell off, and so the portal tract came close, and hepatic arteries increase simultaneously, resulting in FLR around HCC after radiotherapy. In conclusion, the prolapse of hepatocytes and sinusoidal endothelium induced neovascularization of hepatic arteries due to the repair mechanisms; in addition, these prolapse may shorten the distance between each portal region and the hepatic arteries flowing through the portal region become more prominent in FLR.<\/jats:p>","DOI":"10.3390\/diagnostics12051072","type":"journal-article","created":{"date-parts":[[2022,4,25]],"date-time":"2022-04-25T21:16:28Z","timestamp":1650921388000},"page":"1072","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Pathological Appearance of Focal Liver Reactions after Radiotherapy for Hepatocellular Carcinoma"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6896-8419","authenticated-orcid":false,"given":"Masahiro","family":"Okada","sequence":"first","affiliation":[{"name":"Department of Radiology, Nihon University School of Medicine, Itabashi-ku, Tokyo 173-8610, Tokyo, Japan"},{"name":"Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama 232-0024, Kanagawa, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4671-4431","authenticated-orcid":false,"given":"Kazushi","family":"Numata","sequence":"additional","affiliation":[{"name":"Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama 232-0024, Kanagawa, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiromi","family":"Nihonmatsu","sequence":"additional","affiliation":[{"name":"Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama 232-0024, Kanagawa, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kengo","family":"Tomita","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa-shi 359-8513, Saitama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2820-0760","authenticated-orcid":false,"given":"Atsuya","family":"Takeda","sequence":"additional","affiliation":[{"name":"Radiation Oncology Center, Ofuna Chuo Hospital, 6-2-24, Ofuna, Kamakura 247-0056, Kanagawa, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenichiro","family":"Tago","sequence":"additional","affiliation":[{"name":"Department of Radiology, Nihon University School of Medicine, Itabashi-ku, Tokyo 173-8610, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoko","family":"Hyodo","sequence":"additional","affiliation":[{"name":"Department of Radiology, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama 589-8511, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takahisa","family":"Eriguchi","sequence":"additional","affiliation":[{"name":"Radiation Oncology Center, Ofuna Chuo Hospital, 6-2-24, Ofuna, Kamakura 247-0056, Kanagawa, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masayuki","family":"Nakano","sequence":"additional","affiliation":[{"name":"Department of Pathology, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama 232-0024, Kanagawa, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1111\/jgh.12350","article-title":"Stereotactic ablative body radiotherapy for previously untreated solitary hepatocellular carcinoma","volume":"29","author":"Takeda","year":"2014","journal-title":"J. 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Phys."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"208","DOI":"10.3892\/ol.2015.3874","article-title":"Evaluation of contrast-enhanced ultrasonography for hepatocellular carcinoma prior to and following stereotactic body radiation therapy using the CyberKnife\u00ae system: A preliminary report","volume":"11","author":"Shiozawa","year":"2016","journal-title":"Oncol. Lett."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1259\/bjr\/74105551","article-title":"CT evaluations of focal liver reactions following stereotactic body radiotherapy for small hepatocellular carcinoma with cirrhosis: Relation-ship between imaging appearance and baseline liver function","volume":"83","author":"Takeda","year":"2010","journal-title":"Br. J. 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Liver Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"20170118","DOI":"10.1259\/bjr.20170118","article-title":"Stereotactic body radiation therapy (SBRT) for hepatocellular carcinoma: Imaging evaluation post treatment","volume":"91","author":"Kellock","year":"2018","journal-title":"Br. J. Radiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1007\/s11604-015-0465-7","article-title":"Clinical utility of gadoxetate disodium-enhanced hepatic MRI for stereotactic body radiotherapy of hepatocellular carcinoma","volume":"33","author":"Nakamura","year":"2015","journal-title":"Jpn. J. Radiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1186\/1748-717X-8-249","article-title":"Radia-tion-induced liver disease after stereotactic body radiotherapy for small hepatocellular carcinoma: Clinical and dose-volumetric parameters","volume":"8","author":"Jung","year":"2013","journal-title":"Radiat. Oncol."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/12\/5\/1072\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:00:06Z","timestamp":1760137206000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/12\/5\/1072"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,25]]},"references-count":15,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,5]]}},"alternative-id":["diagnostics12051072"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics12051072","relation":{},"ISSN":["2075-4418"],"issn-type":[{"type":"electronic","value":"2075-4418"}],"subject":[],"published":{"date-parts":[[2022,4,25]]}}}