Imaging of hepatic toxicity of systemic therapy in a tertiary cancer centre: chemotherapy, haematopoietic stem cell transplantation, molecular targeted therapies, and immune checkpoint inhibitors
| Autor: | D N Di Salvo, Nikhil H. Ramaiya, Jyothi P. Jagannathan, Sree Harsha Tirumani, Francesco Alessandrino, Katherine M. Krajewski, Atul B. Shinagare |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Oncology
medicine.medical_specialty Pathology medicine.medical_treatment Antineoplastic Agents Hematopoietic stem cell transplantation Cancer Care Facilities Antibodies Monoclonal Humanized 030218 nuclear medicine & medical imaging Tertiary Care Centers 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Molecular Targeted Therapy Liver injury Hepatitis Chemotherapy medicine.diagnostic_test business.industry Decision Trees Hematopoietic Stem Cell Transplantation Cancer Antibodies Monoclonal General Medicine medicine.disease Ipilimumab Transplantation Nivolumab 030220 oncology & carcinogenesis Chemical and Drug Induced Liver Injury business Liver function tests |
| Zdroj: | Clinical radiology. 72(7) |
| ISSN: | 1365-229X |
| Popis: | The purpose of this review is to familiarise radiologists with the spectrum of hepatic toxicity seen in the oncology setting, in view of the different systemic therapies used in cancer patients. Drug-induced liver injury can manifest in various forms, and anti-neoplastic agents are associated with different types of hepatotoxicity. Although chemotherapy-induced liver injury can present as hepatitis, steatosis, sinusoidal obstruction syndrome, and chronic parenchymal damages, molecular targeted therapy-associated liver toxicity ranges from mild liver function test elevation to fulminant life-threatening acute liver failure. The recent arrival of immune checkpoint inhibitors in oncology has introduced a new range of immune-related adverse events, with differing mechanisms of liver toxicity and varied imaging presentation of liver injury. High-dose chemotherapy regimens for haematopoietic stem cell transplantation are associated with sinusoidal obstruction syndrome. Management of hepatic toxicity depends on the clinical scenario, the drug in use, and the severity of the findings. In this article, we will (1) present the most common types of oncological drugs associated with hepatic toxicity and associated liver injuries; (2) illustrate imaging findings of hepatic toxicities and the possible differential diagnosis; and (3) provide a guide for management of these conditions. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect