GI · Organ at risk

Gallbladder

Educational Summary

Dose constraints

Liver SBRT

ScheduleConstraintSource
27.5–60 Gy / 5 fx
HCC or metastases
D0.5 cc ≤55 GyLARK (TROG 17.03)

Within about 1 cm of the gallbladder, one protocol suggests 5 fractions.

Quoted from eviQ 4026, checked 2026-09-29. Full table with references →

Anatomy

A small pear-shaped sac under the right lobe of the liver that stores bile and drains through the cystic duct.

Function in the body

The gallbladder stores and concentrates bile from the liver and releases it into the duodenum after meals.

Why it matters

Relevant mainly for liver SBRT of tumors in the adjacent segments. One liver-metastasis protocol suggests five fractions rather than three when the target is within about 1 cm of the gallbladder, and gives a small-volume limit for five fractions.

How to contour

Both Jabbour 2014 and Timmerman 2022 exclude the gallbladder from the liver contour. Neither gives written boundaries for the gallbladder itself. Written boundaries from an open published source: verified source required.

Review articleSource Verified
A Story of Hypofractionation and the Table on the Wall
Timmerman R · UT Southwestern Medical Center · 2022

An editorial history of the UT Southwestern SABR constraint tables — often called the “Timmerman tables” — covering how they were developed and revised, and their relationship to AAPM TG-101 and NRG/RTOG protocols. Tables 2–11 separate serial tissues (listed with a volume, a volume max and a max point dose) from parallel tissues (listed with a critical volume and a critical-volume dose max). In Tables 2–7 a footnote defines “point” as ≤0.035 cm³; Tables 8–11 add a contouring-instructions column for each structure.

Further reading

  • LARK (TROG 17.03) — Study protocol of the LARK (TROG 17.03) clinical trial: a phase II trial investigating the dosimetric impact of Liver Ablative Radiotherapy using Kilovoltage intrafraction monitoring Source

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