Chemotherapy-associated Liver Injury in patients with colorectal liver metastases: evaluation with 3T MR imaging.

Purpose: To retrospectively evaluate the broad spectrum of liver injury associated with chemotherapy regimens on gadoxetic acid-enhanced 3T MR imaging in patients with colorectal liver metastases (CLM). Materials and methods: From our radiological database we retrospectively selected 3T MR examinations of 65 patients who underwent chemotherapy regimens for the presence of CLM. MR imaging protocol first included axial T1w/T2w sequences and diffusion-weighted MR imaging with multiple b values in all diffusion directions. After intravenous administration of Gd-EOB-DTPA, T1w LAVA sequences were acquired in the dynamic and hepatobiliary phases. Two radiologists in consensus evaluated the qualitative and quantitative liver changes such as sinusoidal obstruction syndrome (SOS) and steatosis. The presence of nodular regenerative hyperplasia (NRH) and peliosis was assessed. Relative liver enhancement (RLE) was measured after 3 and 20 minutes after Gd-EOB-DTPA injection. Our results were then correlated with pathological analysis, when available. Results: SOS was identified in 39/65 patients (low-grade, n=29; medium-grade, n=7; high-grade, n=3), whereas hepatic steatosis was observed in 41/65 subjects (grade I, n=32; grade II, n=3; grade III, n=6). NRH and peliosis were both recognized in 3 patients. The mean values of RLE at 3 minutes and in the HBP were 0.83±0.28 and 1±0.39, respectively. In patients undergoing surgery with pathological analysis (34/65) good agreement was shown between radiological and histological variables for SOS and peliosis and fair agreement for steatosis. Conclusions: Gadoxetic acid–enhanced 3T MR imaging is reliable for detecting SOS and steatosis associated with chemotherapy in patients with CLM