title: Radiation-Induced Liver Injury Mimicking Metastatic Disease in a Patient With Esophageal Cancer: Correlation of Positron Emission Tomography/Computed Tomography With Magnetic Resonance Imaging and Literature Review.
abstract: Post-radiation therapy evaluation of distal esophageal cancers with positron emission tomography/computed tomography can be problematic. Differentiation of recurrent neoplasm from postradiation changes is difficult in areas of fluorodeoxyglucose avidity in adjacent, incidentally irradiated organs. Few studies have described the magnetic resonance imaging appearance of radiation-induced hepatic injury. We report a case of focal radiation-induced liver injury with a new focus of fluorodeoxyglucose uptake on posttreatment positron emission tomography as well as masslike enhancement and signal abnormality on magnetic resonance imaging, thus mimicking new liver metastasis. Correlation with radiation planning images suggested the correct diagnosis, which was confirmed on follow-up imaging.
authors.affiliation: From the Departments of *Radiology, †Radiation Oncology, ‡Cardiothoracic Surgery, and §Hematology-Oncology, University of Texas Southwestern Medical Center, Dallas, TX.
authors.forename: Tiffany M
authors.initials: TM
authors.lastname: Rabe
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yokoo
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Meyer
authors.forename: Kemp H
authors.initials: KH
authors.lastname: Kernstine
authors.forename: David
authors.initials: D
authors.lastname: Wang
authors.forename: Gaurav
authors.initials: G
authors.lastname: Khatri
mesh_terms: D003937:Diagnosis, Differential; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D006801:Humans; D008107:Liver Diseases / Q000000981:diagnostic imaging* / Q000209:etiology*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D011832:Radiation Injuries / Q000000981:diagnostic imaging* / Q000209:etiology; D020266:Radiotherapy, Conformal / Q000009:adverse effects; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity