Re: Diagnostic performance of contrast-enhanced CT-scan in sinusoidal obstruction syndrome induced by chemotherapy of colorectal liver metastases: Radio-pathological correlation

Huang, Zhuoqun; Yang, Hsin-Ping; Lin, Weilong

doi:10.1016/j.ejrad.2017.12.016

Cited by 1 publication

(2 citation statements)

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“…Meanwhile, hepatocytes around the central vein are loose and swollen, with focal steatosis and punctate necrosis. These pathological changes in our study are consistent with the reported expert consensus [ 23 ], and might cause a reduction in effective blood perfusion and an increase in fat content within liver parenchyma [ 24 ]. Previous studies using IVIM-DWI demonstrated the change of effective blood volume before and after chemotherapy and liver fibrosis [ 14 , 17 ], and using PDFF and 25OH-VitD3 demonstrated an increase in fat content of patients with NAFLD [ 33 – 35 , 38 ].…”

Section: Discussionsupporting

confidence: 92%

“…NC-induced liver injury is routinely diagnosed according to serum alanine aminotransferase (ALT) and total bilirubin (TBIL) levels [21]. Currently, contrast-enhanced CT and MRI are recommended as more advantageous qualitative approaches [22][23][24][25]. However, the clinical presentation of NC-induced liver injury requires more intuitive, specific, and quantitative biomarkers for a precise preoperative assessment of liver injury.…”

Section: Introductionmentioning

confidence: 99%

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Quantified MRI and 25OH-VitD3 can be used as effective biomarkers for patients with neoadjuvant chemotherapy-induced liver injury in CRCLM?

Wang

et al. 2020

BMC Cancer

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Background: To evaluate proton-density fat-fraction (PDFF) and intravoxel incoherent motion (IVIM) techniques, and human 25-hydroxyvitamin D3 (25OH-VitD3) levels, as potential biomarkers in patients with colorectal cancer with liver metastasis (CRCLM). Changes were compared with those related to chemotherapy-associated steatohepatitis (CASH) and sinusoidal obstruction syndrome (SOS). Methods: 63 patients with pathologically confirmed colorectal adenocarcinoma received 4-6 courses of NC before liver resection and underwent magnetic resonance imaging (MRI) with iterative decomposition of water and fat with echo asymmetry and least-squares estimation quantification and IVIM sequences. Blood samples were analyzed using CTCAE. Pathological changes of liver tissues outside the metastases were assessed as the gold standard, and receiver operating characteristic (ROC) curves were analyzed. Results: 16 cases had CASH liver injury, 14 cases had SOS changes, and 4 cases had CASH and SOS, and 7 showed no significant changes. Consistency between biochemical indices and pathological findings was poor (kappa = 0.246, p = 0.005). The areas under the ROC curve (AUCs) of ALT, AST, ALP, GGT, and TBIL were 0.571-0.691. AUCs of D, FF, and 25OH-VitD3 exceeded 0.8; when considering these markers together, sensitivity was 85.29% and specificity was 93.13%. ANOVA showed statistically significant differences among D, FF, and 25OH-VitD3 for different grades of liver injury (F = 4.64-26.5, p = 0.000-0.016). Conclusions: D, FF, and 25OH-VitD3 are biomarkers for accurate prediction of NC-induced liver injury in patients with CRCLM, while FF and 25OH-VitD3 might be beneficial to distinguish liver injury grades. Trial registration: Current Trials was retrospectively registered as ChiCTR1800015242 at Chinese Clinical Trial Registry on March 16, 2018.

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