Gd-EOB-DTPA-enhanced MR findings in chemotherapy-induced sinusoidal obstruction syndrome in colorectal liver metastases

J Int Med Res. 2020 Jun;48(6):300060520926031. doi: 10.1177/0300060520926031.

Abstract

Background: We assessed the clinical presentations, biomarkers, and Gd-EOB-DTPA-enhanced MRI features that were associated with oxaliplatin-induced sinusoidal obstruction syndrome (SOS) to detect chemotherapy-associated SOS in a timely manner.

Methods: Fifty-seven patients who underwent oxaliplatin-based chemotherapy and Gd-EOB-DTPA-enhanced MRI were included. Post-oxaliplatin heterogeneity in liver parenchyma was scored on a grading scale of 0 to 3. Abnormal clinical findings, including splenomegaly, hepatomegaly, gall bladder wall thickening, and hepatic vein narrowing, were also assessed. Additionally, alanine transaminase (ALT) levels, aspartate aminotransferase (AST) levels, and platelet counts were measured.

Results: For SOS, 21 patients were scored grade 0, 24 were grade 1, seven were grade 2, and five were grade 3. Hepatomegaly, splenomegaly, gall bladder wall thickening, and hepatic vein narrowing were significantly correlated with the grade for non-tumorous hepatic parenchymal heterogeneity. For laboratory findings, ALT and AST levels, the AST-to-platelet ratio index score, and platelet counts were significantly associated with a high grade (≥2) of non-tumorous hepatic parenchymal heterogeneity.

Conclusions: We assessed the clinical presentations, biomarkers, and Gd-EOB-DTPA-enhanced MRI features that were associated with oxaliplatin-induced sinusoidal obstruction syndrome (SOS) to detect chemotherapy-associated SOS in a timely manner. Additionally, specific laboratory findings were significantly associated with a high grade (≥2).

Keywords: Gd-EOB-DTPA; biomarker; laboratory finding; magnetic resonance imaging; oxaliplatin-based chemotherapy; sinusoidal obstruction syndrome.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents / therapeutic use
  • China
  • Colorectal Neoplasms / metabolism
  • Colorectal Neoplasms / pathology
  • Contrast Media
  • Female
  • Gadolinium DTPA / pharmacology*
  • Hepatic Veno-Occlusive Disease / chemically induced
  • Hepatic Veno-Occlusive Disease / diagnostic imaging*
  • Hepatic Veno-Occlusive Disease / pathology
  • Humans
  • Liver / physiology
  • Liver Neoplasms / pathology
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Neoplasm Metastasis / pathology
  • Oxaliplatin / adverse effects

Substances

  • Antineoplastic Agents
  • Contrast Media
  • gadolinium ethoxybenzyl DTPA
  • Oxaliplatin
  • Gadolinium DTPA