Chemotherapy-treated liver metastases mimicking hemangiomas on MR images.
BACKGROUND
To report the observation that chemotherapy-treated liver metastases may mimic the appearance of hemangiomas on T2-weighted and serial postgadolinium gradient-echo magnetic resonance (MR) images.


METHODS
T2-weighted and serial postgadolinium spoiled gradient-echo images were prospectively and retrospectively analyzed in six patients. All patients had been treated with chemotherapy for a duration of 2-12 months. Histopathologic evaluation of liver lesions was performed in three patients.


RESULTS
Twelve lesions that resembled hemangiomas were identified. Lesions were 0.8-5.5 cm in diameter. All were well defined, oval or lobulated, and demonstrated decreased signal intensity on T1-weighted images and increased signal intensity on T2-weighted images. On immediate postgadolinium images, all lesions demonstrated peripheral nodular enhancement, which coalesced on delayed imaging. Final histopathologic diagnoses were as follows: hepatic metastases from colon cancer (two patients), ovarian cancer (two patients), pancreatic islet cell tumor (one patient), and breast cancer (one patient).


CONCLUSIONS
Metastases treated by chemotherapy may mimic the appearance of hemangiomas on a variety of commonly employed MR techniques. In patients undergoing MR imaging for the evaluation of liver metastases, a history of prior chemotherapy administration and duration should be sought to prevent inaccurate staging and inappropriate therapeutic decision making.
Semelka
R C
RC
Department of Radiology, CB 7510, University of North Carolina, Chapel Hill, NC 27599-7510, USA.
Worawattanakul
S
S
Noone
T C
TC
Burdeny
D A
DA
Kelekis
N L
NL
Woosley
J T
JT
Lee
J K
JK
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D005682:Gadolinium; D006391:Hemangioma / Q000175:diagnosis*; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000556:secondary; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies
D000970:Antineoplastic Agents; D003287:Contrast Media; D005682:Gadolinium