title: Chemotherapy induced liver abnormalities: an imaging perspective.
abstract: Treating patients undergoing chemotherapy who display findings of liver toxicity, requires a solid understanding of these medications. It is important for any clinician to have an index of suspicion for liver toxicity and be able to recognize it, even on imaging. Cancer chemotherapy has evolved, and newer medications that target cell biology have a different pattern of liver toxicity and may differ from the more traditional cytotoxic agents. There are several hepatic conditions that can result and keen clinical as well as radiographic recognition are paramount. Conditions such as sinusoidal obstructive syndrome, steatosis, and pseudocirrhosis are more commonly associated with chemotherapy. These conditions can display clinical signs of acute hepatitis, liver cirrhosis, and even liver failure. It is important to anticipate and recognize these adverse reactions and thus appropriate clinical action can be taken. Often times, patients with these liver manifestations can be managed with supportive therapies, and liver toxicity may resolve after discontinuation of chemotherapy.
authors.affiliation: Department of Internal Medicine, University of California, Irvine, Orange, CA, USA.
authors.forename: Ankush
authors.initials: A
authors.lastname: Sharma
authors.affiliation: Department of Radiological Sciences, University of California, Irvine, Orange, CA, USA.
authors.forename: Roozbeh
authors.initials: R
authors.lastname: Houshyar
authors.affiliation: Department of Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Priya
authors.initials: P
authors.lastname: Bhosale
authors.affiliation: Department of Radiology, Seoul St.Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Joon-Il
authors.initials: JI
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, University of California, Irvine, Orange, CA, USA.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Gulati
authors.affiliation: Department of Radiological Sciences, University of California, Irvine, Orange, CA, USA.
authors.forename: Chandana
authors.initials: C
authors.lastname: Lall
mesh_terms: D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects / Q000627:therapeutic use; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects / Q000627:therapeutic use; D056486:Chemical and Drug Induced Liver Injury / Q000000981:diagnostic imaging / Q000209:etiology; D004791:Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D005234:Fatty Liver / Q000000981:diagnostic imaging / Q000209:etiology; D005260:Female; D006801:Humans; D007167:Immunotherapy; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging / Q000209:etiology; D008107:Liver Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy; D014057:Tomography, X-Ray Computed
chemical_list: D000903:Antibiotics, Antineoplastic; D000964:Antimetabolites, Antineoplastic; D000970:Antineoplastic Agents; D018906:Antineoplastic Agents, Alkylating; D004791:Enzyme Inhibitors
keywords: Chemotherapy; Hepatic Necrosis; Hepatic toxicity; Hepatitis; Pseudocirrhosis; Steatosis