Clin Mol Hepatol.  2014 Sep;20(3):317-326. 10.3350/cmh.2014.20.3.317.

Chemotherapy induced liver abnormalities: an imaging perspective

Affiliations
  • 1Department of Internal Medicine, University of California, Irvine, Orange, CA, USA. ankushs@hs.uci.edu
  • 2Department of Radiological Sciences, University of California, Irvine, Orange, CA, USA.
  • 3Department of Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • 4Department of Radiology, Seoul St.Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

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.

Keyword

Chemotherapy; Hepatic toxicity; Pseudocirrhosis; Steatosis; Hepatic Necrosis; Hepatitis

MeSH Terms

Adult
Aged
Antibiotics, Antineoplastic/adverse effects/therapeutic use
Antimetabolites, Antineoplastic/adverse effects/therapeutic use
Antineoplastic Agents/*adverse effects/therapeutic use
Antineoplastic Agents, Alkylating/adverse effects/therapeutic use
Drug-Induced Liver Injury/etiology/radiography
Enzyme Inhibitors/adverse effects/therapeutic use
Fatty Liver/etiology/radiography
Female
Humans
Immunotherapy
Liver Cirrhosis/etiology/radiography
Liver Diseases/etiology/*radiography
Male
Middle Aged
Neoplasms/therapy
Tomography, X-Ray Computed
Antibiotics, Antineoplastic
Antimetabolites, Antineoplastic
Antineoplastic Agents
Antineoplastic Agents, Alkylating
Enzyme Inhibitors
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