Henry Ho Ching Tam MBBS, Presenter: Nothing to Disclose

Angela Mary Riddell MBBS, Abstract Co-Author: Nothing to Disclose

Gina Brown MD, MBBS, Abstract Co-Author: Nothing to Disclose

Toni Wallace BSc, Abstract Co-Author: Nothing to Disclose

David John Collins BSC, BA, Abstract Co-Author: Nothing to Disclose

Ian Chau, Abstract Co-Author: Nothing to Disclose

Dow-Mu Koh MD, FRCR, Abstract Co-Author: Nothing to Disclose

Reticular hypointensity on T1-weighted gadoxetate-enhanced MRI (EOB MRI) is a feature of sinusoidal obstruction syndrome (SOS) reported with oxaliplatin chemotherapy. However, the prevalence of this appearance is not known. We evaluated the prevalence of SOS on hepatocellular phase EOB MRI in colorectal cancer (CLC) patient treated with chemotherapy, and correlated this pattern with liver dysfunction on serum biochemistry.

IRB approved retrospective review of CLC patients from 2007 to 2011who received neoadjuvant chemotherapy and EOB MRI after treament. MR imaging included in-and-oppose phase T1-weighted, T2-weighted, T1-weighted EOB-MRI (arterial, portovenous, interstitial and 10 minutes delayed) on a 1.5T MR scanner. Images were reviewed blinded to type of chemotherapy for hepatic steatosis, number and location of metastases, presence and extent of reticular hypointensity. Imaging findings were compared with the type of chemotherapy and serum liver function tests (LFTs) using the Chi-squre test.

100 patients were reviewed, of which 74 received oxaliplatin-based chemotherapy and 26 other treatment. Prevalence of reticular T1 hypointensity was 25.6% (19/74) in patients treated with oxaliplatin-based chemotherapy while none of the other patients showed this pattern (chi-square, p=0.004). Reticular T1 hypointensity was diffuse in 11 and segmental in 8. Available histology in 3 patients of this MRI pattern confirmed sinusoidal obstruction. Available histology in 10 patients without this MRI pattern did not show sinusoidal obstruction. None of the patients with reticular T1 hypointensity show hepatic steatosis. LFTs were abnormal in 16 patients with reticular T1 hypointensity compared with 49 in other patients (chi-square, p=0.05).

Diffuse or segmental reticular T1 hypointensity is frequently observed on EOB-MRI in patients receiving oxaliplatin-based chemotherapy and is associated with liver dysfunction but not liver steatosis. 

Recognition of reticular hypoenhancement may allow radiologists and clinicians to identify patients at risk of oxaliplatin-related toxicity and may help to inform decision treatment alteration/termination.

Tam, H, Riddell, A, Brown, G, Wallace, T, Collins, D, Chau, I, Koh, D, Prevalence of Reticular Hypointensity on T1-weighted Gadoxetate Enhanced MRI in Patients Receiving Chemotherapy for Colorectal Cancer.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045755.html