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Accuracy of gadoxetic acid-enhanced magnetic resonance imaging for the diagnosis of sinusoidal obstruction syndrome in patients with chemotherapy-treated colorectal liver metastases.

 Na-Young Shin  ;  Myeong-Jin Kim  ;  Joon Seok Lim  ;  Mi-Suk Park  ;  Yong-Eun Chung  ;  Jin-Young Choi  ;  Ki Whang Kim  ;  Young-Nyun Park 
 EUROPEAN RADIOLOGY, Vol.22(4) : 864-871, 2012 
Journal Title
Issue Date
Adult ; Aged ; Antineoplastic Agents/adverse effects* ; Antineoplastic Agents/therapeutic use ; Colorectal Neoplasms/pathology ; Colorectal Neoplasms/secondary* ; Colorectal Neoplasms/therapy ; Contrast Media ; Female ; Gadolinium DTPA* ; Hepatic Veno-Occlusive Disease/chemically induced ; Hepatic Veno-Occlusive Disease/diagnosis* ; Humans ; Image Enhancement/methods ; Liver Neoplasms/drug therapy* ; Liver Neoplasms/secondary* ; Liver Neoplasms/surgery ; Magnetic Resonance Imaging/methods* ; Male ; Middle Aged ; ROC Curve ; Reproducibility of Results ; Retrospective Studies ; Sensitivity and Specificity
Hepatic veno-occlusive disease ; Magnetic resonance imaging ; Colorectal neoplasms ; Liver neoplasms ; Antineoplastic agents
OBJECTIVE: To assess whether reticular hypointensity on hepatobiliary phase images of gadoxetic acid-enhanced magnetic resonance imaging (EOB-MRI) is a diagnostic finding of sinusoidal obstruction syndrome (SOS) in patients with hepatic metastases who have undergone chemotherapy.

METHODS: We retrospectively analysed EOB-MRI of 42 patients who had undergone chemotherapy before hepatic resection of colorectal hepatic metastases. Two radiologists, who were unaware of whether or not the patients had SOS, reviewed the hepatobiliary phase images to determine the presence of hypointense reticulation in the liver using a 5-point scale. The sensitivity, specificity and area under the receiver operating characteristics curve (A(z)) were calculated for each reviewer.

RESULTS: The sensitivity, specificity and A(z) for the diagnosis of SOS were 75%, 100% and 0.957 for reader 1 and 75%, 96.2% and 0.936 for reader 2, respectively. In one patient who received a false-positive diagnosis by one reader, there was sinusoidal fibrosis on histological examination, but not diagnostic for SOS. False-negative diagnosis occurred in four patients for both readers; histology of these patients showed minimal and localised sinusoidal congestion and fibrosis.

CONCLUSIONS: Reticular hypointensity on hepatobiliary phase images of EOB-MRI is highly specific for the diagnosis of SOS in patients with treated colorectal hepatic metastases.

KEY POINTS: Gadoxetic acid enhanced magnetic resonance imaging (EOB-MRI) can identify the sinusoidal obstruction syndrome (SOS). The diagnosis can be achieved with high specificity and good interobserver agreement. SOS typically demonstrates diffuse hypointensity on hepatobiliary phase images on EOB-MRI. EOB-MRI may be falsely negative in patients with minimal degree of SOS.
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1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ki Whang(김기황)
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
Park, Mi-Suk(박미숙) ORCID logo https://orcid.org/0000-0001-5817-2444
Park, Young Nyun(박영년) ORCID logo https://orcid.org/0000-0003-0357-7967
Shin, Na Young(신나영)
Lim, Joon Seok(임준석) ORCID logo https://orcid.org/0000-0002-0334-5042
Chung, Yong Eun(정용은) ORCID logo https://orcid.org/0000-0003-0811-9578
Choi, Jin Young(최진영) ORCID logo https://orcid.org/0000-0002-9025-6274
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