Cancer Therapy–related Hepatic Injury in Children: Imaging Review from the Pediatric LI-RADS Working Group

作者：Cara E. Morin, Amy B. Kolbe, Adina Alazraki, Govind B. Chavhan, Annie Gill, Juan C. Infante, Geetika Khanna, HaiThuy N. Nguyen, Allison F. O’Neill, Mitchell A. Rees, Akshay Sharma, James E. Squires, Judy Squires, Ali Syed, Elizabeth Tang, Alexander J. Towbin, Gary R. Schooler · 发表于：Radiographics · 年份：2023 · DOI：10.1148/rg.230007 · 被引用次数：14 · 研究领域：Childhood Cancer Survivors' Quality of Life、Hemoglobinopathies and Related Disorders、Acute Lymphoblastic Leukemia research

The liver is the primary organ for the metabolism of many chemotherapeutic agents. Treatment-induced liver injury is common in children undergoing cancer therapy. Hepatic injury occurs due to various mechanisms, including biochemical cytotoxicity, hepatic vascular injury, radiation-induced cytotoxicity, and direct hepatic injury through minimally invasive and invasive surgical treatments. Treatment-induced liver injury can be seen contemporaneous with therapy and months to years after therapy is complete. Patients can develop a combination of hepatic injuries manifesting during and after treatment. Acute toxic effects of cancer therapy in children include hepatitis, steatosis, steatohepatitis, cholestasis, hemosiderosis, and vascular injury. Longer-term effects of cancer therapy include hepatic fibrosis, chronic liver failure, and development of focal liver lesions. Quantitative imaging techniques can provide useful metrics for disease diagnosis and monitoring, especially in treatment-related diffuse liver injury such as hepatic steatosis and steatohepatitis, hepatic iron deposition, and hepatic fibrosis. Focal liver lesions, including those developing as a result of treatment-related vascular injury such as focal nodular hyperplasia–like lesions and hepatic perfusion anomalies, as well as hepatic infections occurring as a consequence of immune suppression, can be anxiety provoking and confused with recurrent malignancy or hepatic metastases, although there often are imaging ...